Part 3 — SANITARY CONDITION OF THE ARMY. (continued 2)

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,

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.

TENTS

The portable house must necessarily be as small as possible, and must be made to give its occupants the smallest endurable space. The English bell-tent contains 512 cubic feet, and lodges twelve to fifteen men, when on march, and eight to twelve men in camp, affording 34 to 64 feet of breathing-space for each. Quartermaster-General Airey says this is the best tent in use.

The American tents are of many varieties in shape and size. The Sibley tent gives 1,052 feet to seventeen or eighteen, and sometimes to twenty men, being 53 to 62 feet for each. The Fremont tent is somewhat larger, and, as used in the cavalry camp at Readville, gave the men more air than the Sibley. Both of these have means of ventilation. The wedge-tent, being the simplest in structure, is most easily pitched, struck, and packed by the soldiers, and therefore used by 58 per cent, of the regiments of the Union army, six me sleeping in each. But as occupied by two of the regiments in Massachusetts, in the summer of 1861, it was the most crowded and unhealthy. Those used by the Second Regiment at West Roxbury, and the Ninth at Long Island, (in Boston Harbor,) were twelve and a half feet long, eight feet wide, and six feet high to the ridge, and held twelve men. Each sleeper had 8–1/3 square feet of floor to rest upon, and 25 cubic feet of air to breathe through the night, with no ventilation, except what air passed in through the door-way, when left open, and through the porous cloth that covered the tent. Some of the tents of one of the regiments encamped at Worcester had 56 feet of floor-surface, and 160 feet of air, which was divided among six men, giving each 27 feet of air.

In all the camps of Massachusetts, and of most armies everywhere, economy, not only of room within the tents, but of ground where they are placed, seems to be deemed very important, even on those fields where there is opportunity for indefinite expansion of the encampment. The British army-regulations prescribe three plans of arranging the tents. The most liberal and loose arrangement gives to each soldier eighty square feet of ground, the next gives forty-two, and the most compact allows twenty-seven feet, without and within his tent. These are densities of population equal to having 348,000, 664,000, and 1,008,829 people on a square mile. But enormous and incredible as this condensation of humanity may seem, we, in Massachusetts, have beaten it, in one instance at least. In the camp of the Ninth Regiment at Long Island, the tents were placed in compact rows, and touched each other on the two sides and at the back. Between the alternate rows there were narrow lanes, barely wide enough for carriages to pass. Thus arranged, the men, when in their tents, were packed at the rate of 1,152,000 on a square mile, or one man on every twenty—two square feet, including the lanes between, as well as the ground under, the tents.

The city of London has 17,678 persons on a square mile, through its whole extent, including the open spaces, streets, squares, and parks. East London, the densest and most unhealthy district, has 175,816 on a mile. Boston, including East and South Boston, but not Washington Village, has 50,805 on a mile; and the Broad-Street section, densely filled with Irish families, had, when last examined for this purpose, in 1845, a density of population at the rate of 413,000 on the same space.

RESULTS OF SANITARY REFORMS.

The errors and losses which have been adverted to are not all constant nor universal: not every army is hungry or has bad cookery; not every one encamps in malarious spots, or sleeps in crowded tents, or is cold, wet, or overworked: but, so far as the internal history of military life has been revealed, they have been and are sufficiently frequent to produce a greater depression of force, more sickness, and a higher rate of mortality among the soldiery than are found to exist among civilians. Every failure to meet the natural necessities or wants of the animal body, in respect to food, air, cleanliness, and protection, has, in its own way, and in its due proportion, diminished the power that might otherwise have been created; and every misapplication has again reduced that vital capital which was already at a discount. These first bind the strong man, and then, exposing him to morbific influences, rob him of his health. Perhaps in none of the common affairs of the world do men allow so large a part of the power they raise and the means they gather for any purpose to be lost, before they reach their object and strike their final and effective blow, as the rulers of nations allow to be lost in the gathering and application of human force to the purposes of war. And this is mainly because those rulers do not study and regard the nature and conditions of the living machines with which they operate, and the vital forces that move them, as faithfully as men in civil life study and regard the conditions of the dead machines they use, and the powers of water and steam that propel them, and form their plans accordingly.

But it is satisfactory to know that great improvements have been made in this respect. From a careful and extended inquiry into the diseases of the army and their causes, it is manifest that they do not necessarily belong to the profession of war. Although sickness has been more prevalent, and death in consequence more frequent, in camps and military stations than in the dwellings of peace, this excess is not unavoidable, but may be mostly, if not entirely, prevented. Men are not more sick because they are soldiers and live apart from their homes, but because they are exposed to conditions or indulge in habits that would produce the same results in civil as in military life. Wherever civilians have fallen into these conditions and habits, they have suffered in the same way; and wherever the army has been redeemed from these, sickness and mortality have diminished, and the health and efficiency of the men have improved.

Great Britain has made and is still making great and successful efforts to reform the sanitary condition of her army. The improvement in the health of the troops in the Crimea in 1856 and 1857 has already been described. The reduction of the annual rate of mortality caused by disease, from 1,142 to 13 in a thousand, in thirteen months, opened the eyes of the Government to the real state of matters in the army, and to their own connection with it. They saw that the excess of sickness and death among the troops had its origin in circumstances and conditions which they could control, and then they began to feel the responsibility resting upon them for the health and life of their soldiers. On further investigation, they discovered that soldiers in active service everywhere suffered more by sickness and death than civilians at home, and then they very naturally concluded that a similar application of sanitary measures and enforcement of the sanitary laws would be as advantageous to the health and life of the men at all other places as in the Crimea. A thorough reform was determined upon, and carried out with signal success in all the military stations at home and abroad. "The late Lord Herbert, first in a royal commission, then in a commission for carrying out its recommendations, and lastly as Secretary of State for War in Lord Palmerston's administration, neglecting the enjoyments which high rank and a splendid fortune placed at his command, devoted himself to the sanitary reform of the army."[75] He saw that the health of the soldiers was perilled more "by bad sanitary arrangements than by climate," and that these could be amended. "He had some courageous colleagues, among whom I must name as the foremost Florence Nightingale, who shares without diminishing his glory."[76] Both of these great sanitary reformers sacrificed themselves for the good of the suffering and perishing soldier. "Lord Herbert died at the age of fifty-one, broken down by work so entirely that his medical attendants hardly knew to what to attribute his death."[77] Although he probed the evil to the very bottom, and boldly laid bare the time-honored abuses, neglects, and ignorance of the natural laws, whence so much sickness had sprung to waste the army, yet he "did not think it enough to point out evils in a report; he got commissions of practical men to put an end to them."[78] A new and improved code of medical regulations, and a new and rational system of sanitary administration, suited to the wants and liabilities of the human body, were devised and adopted for the British army, and their conditions are established and carried out with the most happy results.

These new systems connect with every corps of the army the means of protecting the health of the men, as well as of healing their diseases.

"The Medical Department of the British army includes,—

"1. Director-General, who is the sole responsible administrative head of the medical service.

"2. Three Heads of Departments, to aid the Director-General with their advice, and to work the routine-details.

"A Medical Head, to give advice and assistance on all subjects connected with the medical service and hospitals of the army.

"A Sanitary Head, to give advice and assistance on all subjects connected with the hygiene of the army.

"A Statistical Head, who will keep the medical statistics, case-books, meteorological registers," etc.[79]

Besides these medical officers, there are an Inspector-General of Hospitals, a Deputy Inspector-General of Hospitals, Staff and Regimental Surgeons, Staff and Regimental Assistant-Surgeons, and Apothecaries.

The British army is plentifully supplied with these medical officers. For the army of 118,000 men there were provided one thousand and seventy-five medical officers under full pay in 1859. Four hundred and seventy surgeons and assistant-surgeons were attached to the hundred regiments of infantry.[80]

It is made the duty of the medical officer to keep constant watch over all the means and habits of life among the troops,—"to see that all regulations for protecting the health of troops, in barracks, garrisons, stations, or camps, are duly observed." "He is to satisfy himself as to the sanitary condition of barracks," "as to their cleanliness, within and without, their ventilation, warming, and lighting," "as to the drainage, ash-pits, offal," etc. "He is to satisfy himself that the rations are good, that the kitchen-utensils are sufficient and in good order, and that the cooking is sufficiently varied."[81]

Nothing in the condition, circumstances, or habits of the men, that can affect their health, must be allowed to escape the notice of these medical officers.

In every plan for the location or movement of any body of troops, it is made the duty of the principal medical officer first to ascertain the effect which such movement or location will have upon the men, and advise the commander accordingly. It is his duty, also, to inspect all camp-sites and "give his opinion in writing on the salubrity or otherwise of the proposed position, with any recommendations he may have to make respecting the drainage, preparation of the ground, distance of the tents or huts from each other, the number of men to be placed in each tent or hut, the state of cleanliness, ventilation, and water-supply."[82] "The sanitary officer shall keep up a daily inspection of the whole camp, and especially inform himself as to the health of the troops, and of the appearance of any zymotic disease among them; and he shall immediately, on being informed of the appearance of any such disease, examine into the cause of the same, whether such disease proceed from, or is aggravated by, sanitary defects in cleansing, drainage, nuisances, overcrowding, defective ventilation, bad or deficient water supply, dampness, marshy ground, or from any other local cause, or from bad or deficient food, intemperance, unwholesome liquors, fruit, defective clothing or shelter, exposure, fatigue, or any other cause, and report immediately to the commander of the forces, on such causes, and the remedial measures he has to propose for their removal." "And he shall report at least daily on the progress or decline of the disease, and on the means adopted for the removal of its causes."[83]

Thus the British army is furnished with the best sanitary instruction the nation can afford, to guide the officers and show the men how to live, and sustain their strength for the most effective labor in the service of the country.

To make this system of vigilant watchfulness over the health of the men the more effectual, the medical officer of each corps is required to make weekly returns to the principal medical officer of the command, and this principal officer makes monthly returns to the central office at London. These weekly and monthly returns include all the matters that relate to the health of the troops, "to the sanitary condition of the barracks, quarters, hospitals, the rations, clothing, duties, etc., of the troops, and the effects of these on their health."[84]

Under these new regulations, the exact condition of the army everywhere is always open to the eyes of medical and sanitary officers, and they are made responsible for the health of the soldiers. The consequence has been a great improvement in the condition and habits of the men. Camps have been better located and arranged. Food is better supplied. Cooking is more varied, and suited to the digestive powers. The old plan of boiling seven days in the week is abolished, and baking, stewing, and other more wholesome methods of preparation are adopted in the army-kitchens, with very great advantage to the health of the men and to the efficiency of the military service. Sickness has diminished and mortality very greatly lessened, and the most satisfactory evidence has been given from all the stations of the British army at home and abroad, that the great excess of disease and death among the troops over those of civilians at home is needless, and that health and life are measured out to the soldier, as well as to the citizen, according to the manner in which he fulfils or is allowed to fulfil the conditions established by Nature for his being here.

The last army medical report shows the amount and rate of sickness and mortality of every corps, both in the year 1859, under the new system of watchfulness and proper provision, and at a former period, under the old régime of neglect.

The Foot-Guards, which lost annually 1,415 from diseases of the chest before the reform, lost only 538 in 100,000 from the same cause in 1859.[86]

Among the infantry of the line, the annual attacks of fever were reduced to a little more than one-third, and the deaths from this cause to two-fifths of their former ratio. The cases of zymotic disease were diminished 33 per cent., and the mortality from this class of maladies was reduced 68 per cent.[87]

The same happy accounts of improvement come from every province and every military station where the British Government has placed its armies.

Our present army is in better condition than those of other times and other nations; and more and more will be done for this end. The Government has already admitted the Sanitary Commission into a sort of copartnership in the management of the army, and hereafter the principles of this excellent and useful association will be incorporated with, and become an inseparable part of, the machinery of war, to be conducted by the same hands that direct the movements of the armies, ever present and efficient to meet all the natural wants of the soldier, and to reduce his danger of sickness and mortality, as nearly as possible, to that of men of the same age at home.