Definitions.—Hygiene is a science whose laws have to do with the preservation of health. Sanitation is an art whereby man endeavors to carry out the laws of hygiene. Health is a normal condition of body and mind. Disease is any departure from a state of health. Military hygiene—sometimes referred to as the 'hygiene and sanitation in their relations to an army.' In modern military usage, the adjective sanitary is applied not only to hygienic procedure but also to troops and organizations of the Medical Department.
Scope of Military Hygiene—The practice of military hygiene covers all points which relate to the public health of a civil community—and something more. Public health concerns itself with everything which may unfavorably affect the physical condition of individuals in such a community; in other words, it has to do with man and his environment. This involves a consideration of soil, air, water, climate, habitations, ventilation, heating, care of the person, food, clothing, exercise, occupation, habits, parasites, communicable diseases, disinfection, disposal of refuse, sanitary laws, and vital statistics. The 'something more' is the set of conditions incident to the march, the camp, and battle, which greatly modify the circumstances and increase the difficulties met in the application of sanitary procedures. A knowledge of public health thus falls far short of the requirements for the military service, and physicians called from civil life in time of war, without previous military training, find themselves not qualified properly to safeguard the health of the troops entrusted to their care.
Functions of Medical Officers—Misconceptions as to the functions of the Medical Department are not uncommon even in the army. Since, in time of peace, the medical officer is best known through his relation to the sick, his more important duties may be overlooked. His prime function is, in peace or war, not the cure, but the prevention, of disease. In wartime the evacuation of the sick and wounded to the rear, that they may not encumber the army, is next in importance. The care of the sick, essential though it is from ethical and political considerations, thus assumes relative insignificance from the military standpoint.
Military Failure Due to Preventable Diseases.—In all the wars of history (with the doubtful exception of the Russo-Japanese conflict) much more disability and many more deaths have resulted from disease than from wounds. Campaigns which should have succeeded have frequently failed because of the utter breakdown of armies from preventable diseases, such as cholera, plague, typhoid, typhus, smallpox, malaria, dysentery, and yellow fever. The invasion of Canada by Montgomery and Arnold in 1775 was unsuccessful because of the enormous percentage of losses from smallpox and dysentery. Napoleon’s plan to found a colonial empire in what is now the Southern United States failed because 15,000 men of his fine army, sent out for that purpose in 1802, perished in Santo Domingo of yellow fever and other tropical diseases. The British in the Crimea lost twenty-five times more men from disease than from wounds. Brief as was the war with Spain, deaths from sickness in our army were over seven times more numerous than were those from injury. Even in the Balkan War, recently terminated, the Bulgarian campaign (carried on at first with such fiery vigor and astonishing success) broke down largely because of epidemic disease. The occurrence in one day of about 30,000 cases of a choleraic dysentery was a more vital factor than was the Turkish resistance in the check of the Bulgarian Army at Chatalja and its failure to capture Constantinople.
Results of Prophylaxis.—Up to recent years a high percentage of disease and death during war time has been accepted as unavoidable, and but little effort made to prevent the one or to lessen the other, but the great increase in knowledge of the causes of disease has given us weapons with which to fight these, and the application of sanitary principles has resulted in a marked diminution in many affections now shown to be preventable. The annual death-rate for that half of the United States which keeps reliable statistics has decreased nearly 20 per cent. in the last generation. The average length of life at present is about forty-five years, and it is estimated that methods of disease prevention (so-called prophylaxis), if properly applied, can add fifteen years to this. The sanitarians of our army have kept pace with advances along this line and, since the Spanish War created opportunities for them, have been pioneers in blazing trails through uncharted wildernesses of disease. The conquest of yellow fever in Cuba, of hookworm disease in Porto Rico, of pernicious malaria in Panama, of beriberi among Philippine scouts, of typhoid fever in the army itself, are but a few examples of the marvelous results of the application, to great problems met, of the principles of disease prevention. More recently it has been shown in the large camps along the Mexican border that troops can be maintained under canvas in one place for prolonged periods without an increase in sickness beyond the rates usual in garrisons. As a matter of fact, in time of peace at least, sick rates from preventable diseases are now much less in military than in civil communities.
The Soldier and Disease Prevention.—Soldiers are specialists in a certain branch of human endeavor, the practice of which entails additional risks and creates the necessity for care in avoidance thereof. The risks of battle cannot be avoided, but those of the march and the camp can, as will be shown, be entirely escaped or greatly lessened by the exercise of reasonable caution. The prevention of disease is of supreme importance to officers of the line because the efficiency of the troops they command is dependent upon health. The vital military factor is the soldier himself, and the avoidance of wastage in this particular needs no emphasis. A trained soldier is of more value than are several raw recruits. If such a soldier can be kept in the ranks, or returned thereto promptly after sickness or injury, the system is a great asset to the company commander and to the army. But such a system can be instituted and maintained only by full and hearty co-operation between line and sanitary officers, in association with a high state of discipline. That elusive something, known to us under the French term esprit, is engendered and fostered in troops chiefly by confidence in their officers, and one of the best ways to gain that confidence is by letting the men see and feel the active interest taken in their welfare.
Enforcement of Sanitary Regulations.—When sanitary regulations are promulgated for the guidance of enlisted men, it is often desirable to let them know the reasons therefor. Most of our men are intelligent, thinking individuals, and if their reason is appealed to, compliance is apt to be more thorough than when a mere command is given, without explanation. On the other hand, the issuance of an order by no means ensures compliance. Every order must be followed up, to see that it is carried out promptly and habitually. For this purpose inspections must be made early and often. If a disposition to shirk is observed, delinquents must be punished. Unless the system of inspection and responsibility is thorough and complete and duties of subordinates dovetail or overlap, work will be neglected, because certain things are nobody’s business. A medical officer is on the staff of his commander in an advisory capacity. This relation should not be lost sight of. Recommendations of sanitary officers should be heeded and enforced by commanders.
That one who promptly and firmly supports his sanitary adviser soon finds the sanitation of his camp or garrison maintained at a high standard by those most directly responsible, namely, the company commanders.
Key Takeaways
- Military hygiene is crucial for maintaining troop efficiency and preventing disease outbreaks.
- Preventing preventable diseases can significantly reduce casualties in military operations.
- Sanitary regulations must be enforced with inspections and accountability to ensure compliance.
Practical Tips
- Educate troops on the importance of sanitation and hygiene practices, as they are more likely to comply if their reasoning is understood.
- Regularly inspect camps and barracks for cleanliness and adherence to sanitary regulations.
- Maintain a high state of discipline among soldiers to ensure proper care and prevention of diseases.
Warnings & Risks
- Failure to enforce sanitation can lead to significant health issues, including disease outbreaks that can cripple an army.
- Ignoring the importance of preventive measures can result in higher casualty rates during military operations.
- Lack of cooperation between line officers and sanitary officers can lead to neglect of important hygiene practices.
Modern Application
While many of the specific diseases mentioned may not be as prevalent today, the principles of maintaining a clean environment, educating soldiers on health practices, and enforcing sanitation regulations remain crucial. Modern survival preparedness emphasizes similar concepts, such as water purification, food storage, and first aid training, which are essential for preventing disease in any isolated or emergency situation.
Frequently Asked Questions
Q: What were the main causes of death among soldiers during historical wars according to this chapter?
According to the chapter, much more disability and many more deaths resulted from diseases such as cholera, plague, typhoid, typhus, smallpox, malaria, dysentery, and yellow fever than from wounds in most wars.
Q: How can a medical officer's role be better understood according to the chapter?
The chapter states that while the medical officer is best known for treating sick soldiers, their primary function is disease prevention. They are also responsible for evacuating the sick and wounded from the front lines.
Q: What does the term 'esprit' refer to in this context?
'Esprit' refers to a sense of confidence and unity among soldiers, which can be fostered by showing active interest in their welfare and maintaining high standards of discipline.