[15] "Military History of the Campaign of 1882 in Egypt." Prepared by the Intelligence Branch of the War Office. Revised edition. London, 1908.
CHAPTER VIII
Railway Ambulance Transport
According to statistics which have been compiled in relation to wars alike in ancient and in modern times, for every ten men among the armies in the field who have died from wounds received in battle there have been from thirty-five to forty who died from sickness or disease. Writing in the Journal des Sciences Militaires, Dr. Morache, a surgeon in the French Army, has said that while the total number of deaths among combatants taking part in the Crimean War was 95,000, no fewer than 70,000 were due to typhus, scurvy, cholera or other diseases. In the Italian campaign of 1859 the French lost 5,498 men, of whom 2,500 died from sickness. On the conclusion of the Russo-Turkish War the Russians had 51,000 of their troops sick, the ravages of typhus having been especially severe.
These conditions have been materially aggravated by the gathering together of great numbers of sick and wounded into overcrowded hospitals situate on or near to the theatre of war and destined inevitably to become hot-beds of disease and pestilence far more dangerous to human life, under these conditions, than even the most deadly weapons which the art of war had invented for use on the battle-field itself.
Nor was it the armies alone that suffered. Returning troops spread the seeds of disease among the civil population, causing epidemics that lingered, in some instances, for several years and carried off many thousands of non-combatants, in addition to the great number of victims among the combatants themselves. In a volume of 866 pages, published by Dr. E. Gurlt, under the title of "Zur Geschichte der Internationellen und Freiwilligen Krankenpflege im Kriege" (Leipzig, 1873), will be found many terrible details concerning the ravages in France, Germany and Austria of the typhus which Napoleon's troops brought back with them on the occasion of their disastrous retreat from Russia.
The most practicable means of mitigating, if not of avoiding, these various evils is to be found in the prompt removal of the sick and wounded from the theatre of war, and their distribution in smaller units, not simply among a group of neighbouring towns, but over an area extending to considerable distances inland. The adoption of this remedy only became possible, however, with a provision of adequate rail facilities, and even then many years were to elapse before an efficient system of railway ambulance transport was finally evolved.
The objects which the use of the railway in these directions was to attain were alike humanitarian and strategical.
To the sick and wounded among the troops, prompt removal and widespread distribution among hospitals in the interior meant (1) that they avoided the risks to which they would have been subjected in the aforesaid overcrowded and pestilential hospitals near the fighting line, where slight injuries might readily develop dangerous symptoms, and contagious disease complete the conditions leading to a fatal issue; (2) that, apart from these considerations, it would be possible to give them a greater degree of individual attention if they were distributed among a large number of hospitals away from the scene of the fighting; (3) that more conservative methods of surgery became practicable when operations of a kind not to be attempted either on the battle-field or in temporary hospitals (from which the inmates might have to be suddenly removed, owing to some change in the strategical position) could be delayed until the sufferer's arrival at some hospital in the interior, where better appliances and better facilities would be available, and where, after the operation, the patient would be able to remain undisturbed until he was cured; (4) that these improved conditions might more especially permit of the avoidance of amputations otherwise imperatively necessary; and (5) that, on the whole, the wounded soldier was afforded a better chance of effecting a speedy recovery and of saving both life and limb than would be possible if railways were not available.