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patient, nor even cause him to go to the were expended in making their patients hospital, yet none the less certainly unfit comfortable, in defending them from cold him for labor and duty. Of the regiment and storm, or from suffering in their referred to by Dr. Mann, and already ad- crowded rooms or shanties. They were duced in this article, in which 700 were obliged to devote all their strength to unable to attend to duty, 340 were in the taking care of the present. They could hospital under the surgeon's care, and 360 take little account of the past, and were were ill in camp. It is probable that a often unable to make any record for the similar, though smaller, discrepancy often future. They could not do this for those exists between the surgeon's records and under their own immediate eye in the the absentees from parades, guard-duty, hospital; much less could they do it for etc.
those who remained in their tents, and It is improbable, and even impossible, needed little or no medical attention, that complete records and reports should but only rest. Moreover, the exposures always be made of all who are sick and and labors of the campaign sometimes unfit for duty, or even of all who come diminish the number and force of the under the surgeon's care. Sir John Hall, surgeons as well as of the men, and reprincipal Medical Officer of the British duce their strength at the very moment army in the Crimea, says that there were when the greatest demand is made for “ 218,952 admissions into hospital.” * their exertions. Dr. Mann says, “ The " The general return, showing the pri- sick in the hospital were between six and mary admissions into the hospitals of the seven hundred, and there were only three army in the East, from the 10th April, surgeons present for duty.” “Of seven 1854, to the 30th June, 1856, gives only surgeons attached to the hospital depart162,123 cases of all kinds.”+ But an- ment, one died, three were absent by reaother Government Report states the ad- son of indisposition, and the other three missions to be 162,673. Miss Nightin- were sick.”* Fifty-four surgeons died in gale says,
“ There was, at first, no system the Russian army in Turkey in the sumof registration for general hospitals, for all mer of 1828. “ At Brailow, the pestilence were burdened with work beyond their spared neither surgeons nor nurses.” 1 strength.”S Dr. Mann says, that, in the Sir John Hall says, “ The medical offWar of 1812, “no sick-records were found cers got sick, a great number went away, in the hospital at Burlington," one of the and we were embarrassed.” “ Thirty per largest depositories of the sick then in the cent. were sometimes sick and absent" country. “The hospital-records on the from their posts in the Crimea. Sever Niagara were under no order." || It could ty surgeons died in the French army in hardly have been otherwise. The regi- the same war. It is not reasonable, then, mental hospitals then, as frequently must to suppose that all or nearly all the casbe the case in war, were merely extem- es of sickness, whether in hospital or porized shelters, not conveniences. They in camp, can be recorded, especially at were churches, houses, barns, shops, sheds, times when they are the most abundant. or any building that happened to be with- Nor do the cases of sickness of every in reach, or huts, cabins, or tents sudden
sort, grave and light, recorded and unly created for the purpose. In these all recorded, include all the depressions of the surgeons' time, energy, and resources vital energy and all the suspensions and Report on the Sanitary Condition of the Brit
loss of effective force in the army. Wben. ish Army, p. 180.
ever any general cause of depression Ib., 525. | Medical and Surgical History of the War * Medical Sketches, p. 66. in the East, Vol. II.
| Boudin, Traité de Geographie et de Sta$ Report on the Sanitary Condition of the Brit- tistique Médicales, Tom. II., p. 289. ish Army, p. 377.
| Report on the Sanitary Condition of the Brit|| Medical Sketches, p.
ish Army, p. 180.
weighs upon a body of men, as fatigue, so generally present that the number and cold, storm, privation of food, or malaria, proportion of those who are thus hopeit vitiates the power of all, in various de- lessly reduced below the degree of effigrees and with various results; the weak cient military usefulness, in the British and susceptible are sickened, and all lose army, has been determined by observasome force and are less able to labor and tion, and the Government calculates the attend to duty. No account is taken, rate of the loss which will happen in none can be taken, of this discount of the this way, at any period of service. Out general force of the army; yet it is none of 10,000 men enlisted in their twentythe less a loss of strength, and an imped- first year, 718 will be invalided during iment to the execution of the purposes of the first quinquennial period, or before the Government.
they pass their twenty-fifth year, 539 in the second, 673 in the third, and 854
in the fourth, — making 2,784, or more INVALIDING.
than one-quarter of the whole, discharThe loss of force by death, by sickness ged for disability or chronic ailment, bein hospital and camp, and by temporary fore they complete their twenty years of depression, is not all that the army is sub- military service and their forty years of ject to. Those who are laboring under life. consumption, asthma, epilepsy, insanity, It is further to be considered, that, durand other incurable disorders, and those ing these twenty years, the numbers are whose constitutions are broken, or with- diminishing by death, and thus the ratio ered and reduced below the standard of of the enfeebled and invalided is increasmilitary requirement, are generally, and ed. · Out of 10,000 soldiers who survive by some Governments always, discharged and remain in the army
in cach succesThese pass back to the general communi- sive quinquennial period, 768 will be inty, where they finally die. By this pro- valided in the first, 680 in the second, cess the army is continually sifting out 1,023 in the third, and 1,674 in the its worst lives, and at the same time it fourth. In the first year the ratio is fills their places with bealthy recruits. It 181, in the fifth 129, in the tenth 165, thas keeps up its average of health and in the fifteenth 276, and in the twendiminishes its rate of mortality; but the tieth 411, among 10,000 surviving and sum and the rates of sickness and mor
remaining tality in the community are both there- The depressing and exhaustive force by increased.
of military life on the soldiers is gradualDuring the Crimean War, 17.34 per ly accumulative, or the power of resistcent. were invalided and sent home from ance gradually wastes, from the beginning the British army, and 21 per cent from to the end of service. There is an apthe French army, as unable to do military parent exception to this law in the fact, service. By this means, 11,994 * British that, in the British army, the ratio of and 65,069 † French soldiers were lost to those who were invalided was 181 in their Governments. The army of the 10,000, but diminished, in the second, United States, in the Mexican War, dis- third, and fourth years, to 129 in the charged and sent home 12,252 men, or 12 fifth and sixth, then again rose, through per cent of the entire number engaged all the succeeding years, to 411 in the in that war, on account of disability. twentieth. The experience of the Brit
The causes of this exhaustion of per- ish army, in this respect, is corroborated sonal force are manifold and various, and by that of ours in the Mexican War.
From the old standing army 502, from • Medical and Surgical History of the British
the additional force recently enlisted 548, Army in the East, Vol. II. p. 227. † British antl Foreign Medical and Surgical
and from the volunteers 1,178, in 10,000 Journal, Vol. XXI.
of each, were discharged on account of
disability. Some part of this great dif- very great degree in war, on the soldier, ference between the regulars and volun- and reduce and sicken bim more than teers is doubtless due to the well-known the civilian. His vital force is not 50 fact, that the latter were originally en- well sustained by never failing supplies listed, in part at least, for domestic train- of nutritious and digestible food and reguings, and not for the actual vice of lar nightly sleep, and his powers are more war, and therefore were examined with exhausted in hardships and exposures, in less scrutiny, and included more of the excessive labors and want of due rest weaker constitutions.
and protection against cold and beat, The Sanitary Commission, after in- storms and rains. Consequently the arspecting two hundred and seventeen reg. my suffers mostly from diseases of depresiments of the present army of the United sion, - those of the typhoid, adynamic, States, and comparing the several corps and scorbutic types. MeGrigor says with each other in respect of health, came that, in the British army in the Peninsula, to a similar conclusion. They found that of 176,007 cases treated and recorded by the twenty-four regiments which had the the surgeons, 68,894 were fevers, 23,203 least sickness had been in service one diseases of the bowels, 12,167 ulcers, and hundred and forty days on an average, 4,027 diseases of the lungs.* In the Britand the twenty-four regiments which had ish hospitals in the Crimean War, 39 per the most sickness had been in the field cent. were cholera, dysentery, and diaronly one hundred and eleven days. The rhæa, 19 per cent. fevers, 1.2 per cent Actuary adds, in explanation, —“The scurvy, 8 per cent. diseases of the lungs, difference between the sickness of the 8 per cent. diseases of the skin, 3.3 per older and newer regiments is probably cent. rheumatism, 2.5 per cent diseases attributable, in part, to the constant weed of the brain and nervous system, 1.4 per ing out of the sickly by discharges from cent. frost-bite or mortification produced the service. The fact is notorious, that by low vitality and chills, 13, or one in medical inspection of recruits, on enlist- 12,000, had sunstroke, 257 had the iteb, ment, has been, as a rule, most imperfectly and 68 per cent. of all were of the zymotexecuted; and the city of Washington is ic class,f which are considered as princonstantly thronged with invalids awaiting cipally due to privation, exposure, and their discharge-papers, who at the time of personal neglect. The deaths from these their enlistment were physically unfit for classes of causes were in a somewhat simservice.”* In addition to this, it must ilar proportion to the mortality from all be remembered, that, although all re- stated causes, — being 58 per cent from cruits are apparently perfect in form and cholera, dysentery, and diarrhæa, and 1 free from disease when they enter the per cent. from all other disorders of the army, yet there may be differences in digestive organs, 19 per cent. from fevers, constitutional force, which cannot be de- 3.6 per cent. from diseases of the lungs, tected by the most careful examiners. 1.3 per cent. from rheumatism, 1.3 per Some have more and soine have less cent. from diseases of the brain and ner power of endurance. But the military vous system, and 79 per cent. from those burden and the work of war are arranged of the zymotic class. The same classes and determined for the strongest, and, of of disease, with a much larger proportion course, break down the weak, who retire of typhoid pneumonia, prostrated and de in disability or sink in death.
stroyed many in the American army in the War of 1812.
GENERAL VITAL DEPRESSION.
Two causes of depression operate, to a considerable degree in peace and to a
* MS. Letter of Mr. Elliott.
* Medico-Chirurgical Transactions, Vol. VI. p. 478, etc.
| Report on the Sanitary Condition of the British Army, p. 525. — Medical and Surgical History of the War in the East.
fortieth year, —
DANGERS IN LAND-BATTLES.
In paper No. 40, p. 54, of the Sanitary vitality happen most frequently and are Commission, is a report of the diseases that most fatal. occurred in forty-nine regiments, while Volumes of other facts and statements under inspection about forty days eachmight be quoted to show that military serbetween July and October, 1861. 27,526 vice is exhaustive of vital force more than cases were reported; of these 67 per the pursuits of civil life. It is so even in cent were zymotic, 41 per cent diseases time of peace, and it is remarkably so in of the digestive organs, 22 per cent. fe- time of war. Comparing the English statevers, 7 per cent. diseases of the lungs, ments of the mortality in the army with 5 per cent. diseases of the brain. Among the calculations of the expectation of life males of the army-ages the proportions of in the general community, the difference deaths from these classes of causes to those is at once manifest. from all causes were, in Massachusetts, in Of 10,000 men at the age of twenty, 1859, zymotic 15 per cent., diseases of di- there will die before they complete their gestive organs 3.6 per cent., of lungs 50 per cent., fevers 9 per cent., diseases of brain 4.6 per cent.* According to the
British army in time of peace, .
England and Wales, English Life-Table, 1,853 mortality-statistics of the seventh census
According to tables of Amicable and of the United States, of the males between
Equitable Life-Insurance Companies, 1,972 the ages of twenty and fifty, in Mary- New England and New York, accordland, Virginia, North Carolina, South ing to the tables of the New England Carolina, and Georgia, whose deaths in
Mutual Life Insurance Company, 1,721 the year ending June 1st, 1850, and their causes, were ascertained and reported by the marshals, 34.3 per cent. died of zymotic diseases, 8 per cent. of all the dis- Tais large amount of disease and moreases of the digestive organs, 30.8 per tality in the army arises not from the cent. of diseases of the respiratory organs,
battle-field, but belongs to the camp, the 24.4 per cent. of fevers, and 5.7 per cent. tent, the barrack, the cantonment; and it of disorders of the brain and nervous sys- is as certain, though not so great, in time tem. In England and Wales, in 1858, of peace, when no harm is inflicted by these proportions were, zymotic 14 per
the instruments of destruction, as in time cent., fevers 8 per cent., diseases of di
The battle, which is the world's gestive organs 7.9 per cent., of lungs 8 terror, is comparatively harmless. The per cent., and of the brain 7 per cent.
official histories of the deadly struggles If, however, we analyze the returns of of armies show that they are not so wastemortality in civil life, and distinguish those ful of life as is generally supposed. Mr. of the poor and neglected dwellers in the William Barwick Hodge examined the crowded and filthy lanes and alleys of records and despatches in the War-Office cities, whose animal forces are not well in London, and from these and other developed, or are reduced by insuffi- sources prepared an exceedingly valuacient and uncertain nutrition, by poor ble and instructive paper on “ The Morfood or bad cookery, by foul air within tality arising from Military Operations,” and stenchy atmosphere without, by im- which was read before the London Statisperfect protection of house and clothing, tical Society, and printed in the ninewe shall find the same diseases there as teenth volume of the Society's journal. in the army. Wherever the vital forces Some of the tables will be as interesting are depressed, there these diseases of low to Americans as to Englishmen.
the following page is a tabular view, • Calculated from the Eighteenth Registra
taken from this work, of the casualties + Calculated from Twenty-First Report of
in nineteen battles fought by the British Registrar General.
armies with those of other nations.
1801, March 21,
July 28... 1810, September 27, 1811, March 5,
16, 1812, July 22,.. 1813, June 21, .
July 25 to August 2,..
56,000 57.000 14,500 35,200 37,000 54.200 95,800 65,000 90,600 43,600 54,400
6.268 1,300 1,610 1,469 6,500 4,964 4,829 6,540 2,621 2,200 4,641
TABLE I.- NINETEEN LAND-BATTLES.
BRITISH AND ALLIES.
Deaths in battle,
Per 1000 engaged.
Estimated deaths among the wounded.