HEALTH IN THE CAMP
All the world has heard a great deal of the sufferings and mortality of the English and French armies in the late Russian war; and in most countries the story has been heard to some purpose. Reforms and new methods have been instituted in almost every country in Europe,—so strong has been the effect of the mere outline of the case, which is all that has been furnished to the public. The broad facts of the singular mortality first, and the singular healthfulness of the British army afterwards, on the same spot and under the same military circumstances as before, have interested all rulers of armies, and brought about great benefits to the soldier, throughout the length and breadth of Europe. Within these broad outlines there was a multitude of details which were never recorded in a systematic way, or which, for good and sufficient reasons, could not be made public at the time; and these details are the part of the story most interesting to soldiers actually in the field or likely to be called there soon. They are also deeply interesting to every order of persons concerned in a civil war; for such a war summons forth a citizen soldiery to form a system for themselves in regard to the life of the march and the camp, and to do the best they can for that life and health which they have devoted to their country. Under such circumstances it cannot but be interesting to the patriots in the camp and to their families at home to know some facts which they cannot have heard before of the mistakes made at the beginning of the last Russian war, and the repair of those mistakes before the end of it. The prompt and anxious care exercised by the American Sanitary Commission, and the benevolent diligence bestowed on the organization of hospitals for the Federal forces, show that the lesson of the Crimean campaign has been studied in the United States; and this is an encouragement to afford further illustrations of the case, when new material is at command.
I am thinking most of the volunteer forces at this moment, for the obvious reason that their health is in greater danger than that of the professional soldier. The regular troops live under a system which is always at work to feed, clothe, lodge, and entertain them: whereas the volunteers are quitting one mode of life for another, all the circumstances of which had to be created at the shortest notice. To them their first campaign must be very like what it was to British soldiers who had never seen war to be sent to Turkey first, and then to the Crimea, to live a new kind of life, and meet discomforts and dangers which they had never dreamed of. I shall therefore select my details with a view to the volunteers and their friends in the first place.
The enthusiasm which started the volunteers of every Northern State on their new path of duty could hardly exceed that by which the British troops were escorted from their barrack-gates to the margin of the sea. The war was universally approved (except by a clique of peace-men); and there was a universal confidence that the troops would do their duty well, though not one man in a thousand of them had ever seen war. As they marched down to their ships, in the best mood, and with every appearance of health and spirit, nobody formed any conception of what would happen. Parliament had fulfilled the wishes of the people by voting liberal sums for the due support of the troops; the Administration desired and ordered that everything should be done for the soldier's welfare; and as far as orders and arrangements went, the scheme was thoroughly well intended and generous. Who could anticipate, that, while the enemy never once gained a battle or obtained an advantage over British or French, two-thirds of that fine stout British force would perish in a few months? Of the twenty-five thousand who went out, eighteen thousand were dead in a year; and the enemy was answerable for a very small proportion of those deaths. Before me lie the returns of six months of those twelve, showing the fate of the troops for that time; and it furnishes the key to the whole story.
In those six months, the admissions into hospital in the Crimea (exclusive of the Santari Hospital) were 52,548. The number shows that many must have entered the hospitals more than once, as well as that the place of the dead was supplied by new comers from England. Of these, nearly fifty thousand were absolutely untouched by the Russians. Only 3,806 of the whole number were wounded. Even this is not the most striking circumstance. It is more impressive that three-fourths of the sick suffered unnecessarily. Seventy-five per cent. of them suffered from preventable diseases. That is, the naturally sick were 12,563; while the needlessly sick were 36,179. When we look at the deaths from this number, the case appears still more striking. The deaths were 5,359; and of these scarcely more than the odd hundreds were from wounds,—that is, 373. Of the remainder, little more than one-tenth were unavoidable deaths. The natural deaths, as we may call them, were only 521; while the preventable deaths were 4,465. Very different would have been the spirit of the parting in England, if the soldiers' friends had imagined that so small a number would fall by Russian gun or bayonet, or by natural sickness, while the mortality from mismanagement would at one season of the next year exceed that of London in the worst days of the Great Plague.
That the case was really what is here represented was proved by the actual prevention of this needless sickness during the last year of the war. In the same camp, and under the same circumstances of warfare, the mortality was reduced, by good management, to a degree unhoped for by all but those who achieved it. The deaths for the last half year were one-third fewer than at home! And yet the army that died was composed of fine, well-trained troops; while the army that lived and flourished was of a far inferior material when it came out,—raw, untravelled, and unhardened to the military life.
How did these things happen? There can be no more important question for Americans at this time.
I will not go into the history of the weaknesses and faults of the administration of departments at home. They have been abundantly published already; and we may hope that they bear no relation to the American case. It is more interesting to look into the circumstances of the march and the camp, for illustration of what makes the health or the sickness of the soldier.
Wherever the men were to provide themselves with anything to eat or to wear out of their pay, they were found to suffer. There is no natural market, with fair prices, in the neighborhood of warfare; and, on the one hand, a man cannot often get what he wishes, and, on the other, he is tempted to buy something not so good for him. If there are commissariat stores opened, there is an endless accumulation of business,—a mass of accounts to keep of the stoppages from the men's pay. On all accounts it is found better for all parties that the wants of the soldier should be altogether supplied in the form of rations of varied food and drink, and of clothing varying with climate and season.
In regard to food, which comes first in importance of the five heads of the soldier's wants, the English soldier was remarkably helpless till he learned better. The Russians cut that matter very short. Every man carried a certain portion of black rye bread and some spirit. No cooking was required, and the men were very independent. But the diet is bad; and the Russian regiments were composed of sallow-faced men, who died "like flies" under frequently recurring epidemics. The Turks were in their own country, and used their accustomed diet. The French are the most apt, the most practised, and the most economical managers of food of any of the parties engaged in the war. Their campaigns in Algeria had taught them how to help themselves; and they could obtain a decent meal where an Englishman would have eaten nothing, or something utterly unwholesome. The Sardinians came next, and it was edifying to see how they could build a fire-place and obtain a fire in a few minutes to boil their pot. In other ways both French and Sardinians suffered miserably when the British had surmounted their misfortunes. The mortality from cholera and dysentery in the French force, during the last year, was uncalculated and unreported. It was so excessive as, in fact, to close the war too soon. The Sardinians were ravaged by disease from their huts being made partly under ground. But, so far as the preparation of their food went, both had the advantage of the British, in a way which will never happen again. I believe the Americans and the English are bad cooks in about the same degree; and the warning afforded by the one may be accepted by the other.
At the end of a day, in Bulgaria or the Crimea, what happened was this.
The soldiers who did not understand cooking or messing had to satisfy their hunger any way they could. They were so exhausted that they were sure to drink up their allowance of grog the first moment they could lay hands on it. Then there was hard biscuit, a lump of very salt pork or beef, as hard as a board, and some coffee, raw. Those who had no touch of scurvy (and they were few) munched their biscuit while they poked about everywhere with a knife, digging up roots or cutting green wood to make a fire. Each made a hole in the ground, unless there was a bank or great stone at hand, and there he tried, for one half-hour after another, to kindle a fire. When he got up a flame, there was his salt meat to cook: it ought to have been soaked and stewed for hours; but he could not wait; and he pulled it to pieces, and gnawed what he could of it, when it was barely warm. Then he had to roast his coffee, which he did in the lid of his camp-kettle, burning it black, and breaking it as small as he could, with stones or anyhow. Such coffee as it would make could hardly be worth the trouble. It was called by one of the doctors charcoal and water. Such a supper could not fit a man for outpost duty for the night, nor give him good sleep after the toils of the day.
The Sardinians, meantime, united in companies, some members of which were usually on the spot to prepare supper for the rest. They knew how to look for or provide a shelter for their fire, if only a foot high; and how to cut three or four little trenches, converging at the fire, so as to afford a good draught which would kindle even bad fuel. They had good stews and porridge and coffee ready when wanted. The French always had fresh bread. They carried portable ovens and good bakers. The British had flour, after a time, but they did not know how to make bread; and if men volunteered for the office, day after day, it usually turned out that they had a mind for a holiday, and knew nothing of baking; and their bread came out of the oven too heavy, or sour, or sticky, or burnt, to be eaten. As scurvy spread and deepened, the doctors made eager demands on Government for lime-juice, and more lime-juice. Government had sent plenty of lime-juice; but it was somehow neglected among the stores for twenty-four days when it was most wanted, as was the supply of rice for six weeks when dysentery was raging. All the time, the truth was, as was acknowledged afterwards, that the thing really wanted was good food. The lime-juice was a medicine, a specific; but it could be of no real use till the frame was nourished with proper food.
When flour, and preserved vegetables, and fresh meat were served out, and there were coffee-mills all through the camp, the men were still unable to benefit by the change as their allies did. They could grind and make their coffee; but they were still without good fresh bread and soup. They despised the preserved vegetables, not believing that those little cakes could do them any good. When they learned at last how two ounces of those little cakes were equal, when well cooked, to eight ounces of fresh vegetables, and just as profitable for a stew or with their meat, they duly prized them, and during the final healthy period those pressed vegetables were regarded in the camp as a necessary of life. By that time, Soyer's zeal had introduced good cookery into the camp. Roads were made by which supplies were continually arriving. Fresh meat abounded; and it was brought in on its own legs, so that it was certain that beef was beef, and mutton mutton, instead of goat's flesh being substituted, as in Bulgaria. By that time it was discovered that the most lavish orders at home and the profusest expenditure by the commissariat will not feed and clothe an army in a foreign country, unless there is some agency, working between the commissariat and the soldiers, to take care that the food is actually in their hands in an eatable form, and the clothes on their backs.
It is for American soldiers to judge how much of this applies to their case. The great majority of the volunteers must be handy, self-helping men; and bands of citizens from the same towns or villages must be disposed and accustomed to concerted action; but cooking is probably the last thing they have any of them turned their hand to. Much depends on the source of their food-supply. I fear they live on the country they are in,—at least, when in the enemy's country. This is very easy living, certainly. To shoot pigs or fowls in road or yard is one way of getting fresh meat, as ravaging gardens is a short way of feasting on vegetables. But supposing the forces fed from a regular commissariat department, is there anything to be learned from the Crimean campaigns?
The British are better supplied with the food of the country, wherever they are, than the French, because it is their theory and practice to pay as they go; whereas it is the French, or at least the Bonapartist theory and practice, to "make the war support itself," that is, to live upon the people of the country. In the Peninsular War, the French often found themselves in a desert where they could not stay; whereas, when Wellington and his troops followed upon their steps, the peasants reappeared from all quarters, bringing materials for a daily market. In the Crimea, the faithful and ready payments of the English commissariat insured plenty of food material, in the form of cattle and flour, biscuit and vegetables. The defect was in means of transport for bringing provisions to the camp. The men were trying to eat hard salt meat and biscuit, when scurvy made all eating difficult, while herds of cattle were waiting to be slaughtered, and ship-loads of flour were lying seven miles off. Whole deck-loads of cabbages and onions were thrown into the sea, while the men in camp were pining for vegetable food. An impracticable track lay between; and the poor fellows died by thousands before the road could be made good, and transport-animals obtained, and the food distributed among the tents and huts. Experience taught the officers that the food should be taken entire charge of by departments of the army till it was actually smoking in the men's hands. There were agents, of course, in all the countries round, to buy up the cattle, flour, and vegetables needed. The animals should be delivered at appointed spots, alive and in good condition, that there might be no smuggling in of joints of doubtful character. There should be a regular arrangement of shambles, at a proper distance from the tents, and provided with a special drainage, and means of disposing instantly of the offal. Each company in the camp should have its kitchen, and one or two skilled cooks,—one to serve on each day, with perhaps two assistants from the company. After the regular establishment of the kitchens, there was always food ready and coffee procurable for the tired men who came in from the trenches or outpost duty; and it was a man's own fault, if he went without a meal when off duty.
It was found to be a grave mistake to feed the soldiers on navy salt beef and pork. Corned beef and pork salted for a fortnight have far more nourishment and make much less waste in the preparation than meat which is salted for a voyage of months. After a time, very little of the hard salted meat was used at all. When it was, it was considered essential to serve out peas with the pork, and flour, raisins, and suet, for a pudding, on salt-beef days. In course of time there were additions which made considerable variety: as rice, preserved potatoes, pressed vegetables, cheese, dried fruits and suet for puddings, sugar, coffee properly roasted, and malt liquor. Beer and porter answer much better than any kind of spirit, and are worth pains and cost to obtain. With such variety as this, with portable kitchens in the place of the cumbersome camp-kettle per man, with fresh bread, well-cooked meat and vegetables, and well-made coffee, the soldiers will have every chance of health that diet can afford. Whereas hard and long-kept salt meat, insufficiently soaked and cooked, and hastily broiled meat or fowls, just killed, and swallowed by hungry men unskilled in preparing food, help on diseases of the alimentary system as effectually as that intemperance in melons and cucumbers and unripe grapes and apples which has destroyed more soldiers than all the weapons of all enemies.
So much for the food. Next in order come the clothing, and care of the person.
The newspapers have a great deal to say, as we have all seen, about the badness of much of the clothing furnished to the Federal troops. There is no need to denounce the conduct of faithless contractors in such a case; and the glorious zeal of the women, and of all who can help to make up clothing for the army, shows that the volunteers at least will be well clad, if the good-will of society can effect it. Whatever the form of dress, it is the height of imprudence to use flimsy material for it.
It seems to be everywhere agreed, in a general way, that the soldier's dress should be of an easy fit, in the first place; light enough for hot weather and noon service, with resources of warmth for cold weather and night duty. In Europe, the blouse or loose tunic is preferred to every other form of coat, and knickerbockers or gaiters to any form of trousers. The shoe or boot is the weak point of almost all military forces. The French are getting over it; and the English are learning from them. The number of sizes and proportions is, I think, five to one of what it used to be in the early part of the century, so that any soldier can get fitted. The Duke of Wellington wrote home from the Peninsula in those days,—"If you don't send shoes, the army can't march." The enemy marched away to a long distance before the shoes arrived; and when they came, they were all too small. Such things do not happen now; but it often does happen that hundreds are made footsore, and thrown out of the march, by being ill-shod; and there seems reason to believe that much of the lagging and apparent desertion of stragglers in the marches of the volunteers of the Federal army is owing to the difficulty of keeping up with men who walk at ease. If the Southern troops are in such want of shoes as is reported, that circumstance alone is almost enough to turn the scale, provided the Northern regiments attain the full use of their feet by being accurately fitted with stout shoes or boots. During the darkest days in the Crimea, those who had boots which would stick on ceased to take them off. They slept in them, wet or dry, knowing, that, once off, they could never be got on again. Such things cannot happen in the Northern States, where the stoppage of the trade in shoes to the South leaves leather, skill, and time for the proper shoeing of the army; but it may not yet be thoroughly understood how far the practical value of every soldier depends on the welfare of his feet, and how many sizes and proportions of shoe are needed for duly fitting a thousand men.
As for the rest, the conclusion after the Crimean campaign was that flannel shirts answer better than cotton on the whole. If the shirt is cotton, there must be a flannel waistcoat; and the flannel shirt answers the purpose of both, while it is as easily washed as any material. Every man should have a flannel bandage for the body, in case of illness, or unusual fatigue, or sudden changes of temperature. The make and pressure of the knapsack are very important, so that the weight may be thrown on the shoulders, without pressure on the chest or interference with the arms. The main object is the avoidance of pressure everywhere, from the toe-joints to the crown of the head. For this the head-covering should be studied, that it may afford shelter and shade from heat and light, and keep on, against the wind, without pressure on the temples or forehead. For this the neck-tie should he studied, and the cut of the coat-chest and sleeve, when coats must be worn: and every man must have some sort of overcoat, for chilly and damp hours of duty. There is great danger in the wearing of water-proof fabrics, unless they are so loose as to admit of a free circulation of air between them and the body.
With the clothing is generally connected the care of the person. It is often made a question, With whom rests the responsibility of the personal cleanliness of the soldier? The medical men declare that they do what they can, but that there is nothing to be said when the men are unsupplied with water; and all persuasions are thrown away when the poor fellows are in tatters, and sleeping on dirty straw or the bare ground. The indolent ones, at least, go on from day to day without undressing, combing, or washing, till they are swarming with vermin; and then they have lost self-respect. But if, before it is too late, there is an issue of new shirts, boots, stockings, comforters, or woollen gloves, the event puts spirit into them; they will strip and wash, and throw out dirt and rags from their sleeping-places, and feel respectable again.
Perhaps the first consideration should be on the part of the quartermaster, whose business it is to see to the supply of water; and the sanitary officer has next to take care that every man gets his eight or ten gallons per day. If the soldiers are posted near a stream which can be used for bathing and washing clothes, there ought to be no difficulty; and every man may fairly be required to be as thoroughly washed from head to foot every days and as clean in his inner clothing, as his own little children at home. If on high and dry ground, where the water-supply is restricted, some method and order are needed; but no pains should be spared to afford each man his eight or ten gallons.
This cannot be done, unless the source of supply is properly guarded. When unrestrained access is afforded to a spring-head or pond, the water is fatally wasted and spoiled. In the Crimea, the English officers had to build round the spring-heads, and establish a regular order in getting supplied. Where there is crowding, dirt gets thrown in, the water is muddied, or animals are brought to drink at the source. This ruins everything; for animals will not drink below, when the mouth of horse, mule, or cow has touched the water above. The way is for guardians to take possession, and board over the source, and make a reservoir with taps, allowing water to be taken first for drinking and washing purposes, a flow being otherwise provided by spout and troughs for the animals, and for cleansing the camp. The difference on the same spot was enormous between the time when a British sergeant wrote that he was not so well as at home, and could not expect it, not having had his shoes or any of his clothes off for five months, and the same time the next year, when every respectable soldier was fresh and tidy, with his blood flowing healthfully under a clean skin. The poor sergeant said, in his days of discomfort: "I wonder what our sweethearts would think of us, if they were to see us now,—unshaved, unwashed, and quite old men!" Cut in a year, those who survived had grown young again,—not shaven, perhaps, for their beards were a great natural comfort on winter duty, but brushed and washed, in vigorous health, and gay spirits.
The next consideration is the soldier's abode,—whether tent, or hut, or quarters.
I have shown certain British doctors demanding lime-juice when food was necessary first. In the same way, there was a cry from the same quarter for peat charcoal, instead of preventing the need of disinfectants. Wherever men are congregated in large numbers,—in a caravan, at a fair in the East or a protracted camp-meeting in the far West, or as a military force anywhere, there is always animal refuse which should not be permitted to lie about for a day or an hour. Dead camels among Oriental merchants, dead horses among Western soldiers, are the cause of plague. It is to be hoped that there will never be a military encampment again without the appointment of officers whose business it shall be to see that all carrion, offal, and dirt of every kind is put away into its proper place instantly. For those receptacles, and for stables and shambles, peat charcoal is a great blessing; but it ought not to be needed in or about the abodes of the men. The case is different in different armies. The French have a showy orderliness in their way of settling themselves on new ground,—forming their camp into streets, with names painted up, and opening post-office, cafés, and bazaars of camp-followers; but they are not radically neat in their ways. In a few days or weeks their settlement is a place of stench, turning to disease; and thus it was, that, notwithstanding their fresh bread, and good cookery, and clever arrangements, they were swept away by cholera and dysentery, to an extent unrevealed to this day, while the British force, once well fed and clothed, had actually only five per cent sick from all causes, in their whole force.
The Sardinians suffered, as I have already observed, from their way of making their huts. They excavated a space, to the depth of three or four feet, and used the earth they threw out to embank the walls raised upon the edge of the excavation. This procured warmth in winter and coolness in hot weather; but the interior was damp and ill-ventilated; and as soon as there was any collection of refuse within, cholera and fever broke out. It is essential to health that the dwelling should be above ground, admitting the circulation of air from the base to the ridge of the roof, where there should be an escape for it at all hours of the day and night.
Among volunteer troops in America, the difficulty would naturally seem to be the newness of the discipline, the strangeness of the requisite obedience. Something must be true of all that is said of the scattering about of food, and other things which have no business to lie about on the ground. A soldier is out of his duty who throws away a crust of bread or meat, or casts bones to dogs, or in any way helps to taint the air or obstruct the watercourses or drains. It may be troublesome to obey the requisitions of the sanitary authorities; but it is the only chance for escaping camp-disease.
On the other hand, in fixing on a spot for encampment, it is due to the soldier to avoid all boggy places, and all places where the air is stagnant from inclosure by woods, or near burial-grounds, or where the soil is unfavorable to drainage. The military officer must admit the advice of the sanitary officer in the case, though he may not be always able to adopt it. When no overwhelming military considerations interfere, the soldiers have a right to be placed on the most dry and pervious soil that may offer, in an airy situation, removed from swamps and dense woods, and admitting of easy drainage. Wood and water used to be the quartermaster's sole demands; now, good soil and air are added, and a suitable slope of the ground, and other minor requisites.
It depends on the character of the country whether quarters in towns and villages are best, or huts or tents. In Europe, town quarters are found particularly fatal; and the state of health of the inmates of tents and huts depends much on the structure and placing of either. Precisely the same kind of hut in the Crimea held a little company of men in perfect health, or a set of invalids, carried out one after another to their graves. Nay, the same hut bore these different characters, according to its position at the top of a slope, or half-way down, so as to collect under its floor the drainage from a spring. American soldiers, however, are hardly likely to be hutted, I suppose; so I need say no more than that in huts and tents alike it is indispensable to health that there should be air-holes,—large spaces, sheltered from rain,—in the highest part of the structure, whether the entrance below be open or closed. The sanitary officers no doubt have it in charge to see that every man has his due allowance of cubic feet of fresh air,—in other words, to take care that each tent or other apartment is well ventilated, and not crowded. The men's affair is to establish such rules among comrades as that no one shall stop up air-holes, or overcrowd the place with guests, or taint the air with unwholesome fumes. In the British army, bell-tents are not allowed at all as hospital tents. Active, healthy men may use them in their resting hours; but their condemnation as abodes for the sick shows how pressing is the duty of ventilating them for the use of the strongest and healthiest.
A sound and airy tent being provided, the next consideration is of bedding.
The surgeons of the British force were always on the lookout for straw and hay, after being informed at the outset that the men could not have bedding, though it was hoped there was enough for the hospitals. A few nights in the dust, among the old bones and rubbish of Gallipoli, and then in the Bulgarian marshes, showed that it would be better to bestow the bedding before the men went into hospital, and sheets of material were obtained for some of them to lie upon. A zealous surgeon pointed out to the proper officer that this bedding consisted in fact of double ticking, evidently intended as paillasses, to be stuffed with straw. The straw not being granted, he actually set to work to make hay; and, being well aided by the soldiers, he soon saw them sleeping on good mattresses. It was understood in England, and believed by the Government, that every soldier in camp had three blankets; and after a time, this came true: but in the interval, during the damp autumn and bitter winter, they had but one. Lying on wet ground, with one damp and dirty blanket over them, prepared hundreds for the hospital and the grave. The mischief was owing to the jealousy of some of the medical authorities, in the first place, who would not see, believe, or allow to be reported, the fact that the men were in any way ill-supplied, because these same doctors had specified the stores that would be wanted,—and next, to the absence of a department for the actual distribution of existing stores. With the bedding the case was the same as with the lime-juice and the rice: there was plenty; but it was not served out till too late. When the huts were inhabited, in the Crimea, and the wooden platforms had a dry soil beneath, and every man had a bed of some sort and three blankets, there was no more cholera or fever.