4. The Russo-Japanese War of 1904–5
The apprehension that the Russo-Japanese War would be accompanied by severe outbreaks of infectious diseases turned out to be groundless. The chief danger that threatened both armies was typhoid fever, which is endemic in Manchuria, and which, on account of the filthy condition of the Chinese villages, was given an excellent opportunity to spread. In the first place, the soldiers were prevented from being infected by the fact that they were allowed to drink nothing but boiled water, and were always supplied with hot water for tea; in the second place, when they were called upon to remain in one place for a considerable length of time, they were quartered, not in the Chinese villages, but in earth-huts; or, if they were compelled to live in the Chinese villages, these were always thoroughly disinfected beforehand. Whenever it was possible, the Japanese military physicians, before the troops arrived in a village, investigated the place with reference to hygienic conditions and subjected the inhabitants to an examination. Notwithstanding all this, large numbers of soldiers on both sides, in the course of the war, which lasted twenty-one months, contracted typhoid fever, diarrhoea, and dysentery. In both summers, which are very hot in Manchuria, typhoid fever made its appearance, to a greater extent in the second than in the first, since the troops before and after the battle of Mukden remained encamped for a long time in one and the same place.[[314]] According to the statements of the Russian General Medical Staff,[[315]] the total number of deaths in the Russian army (excluding the troops at Port Arthur and the fleet) caused by diseases was 7,960, and to these must be added the deaths among the discharged troops; the total number of men in the Russian army was 709,587. Even if these figures are incomplete, nevertheless they distinctly show that epidemic diseases, considering the long duration of the war, were not very prevalent. The reports of foreigners who accompanied the Russian army agree in pronouncing the general condition of health excellent.[[316]] Spotted fever and anthrax were also observed, but among both the Russians and the Japanese they appeared only sporadically. According to Follenfant,[[317]] 56,717 cases of infectious diseases occurred among the Russians; of these 25,800 were enterorrhoea, 15,800 were typhoid fever, 8,970 were dysentery, and 4,500 were malaria. Regarding the prevalence of disease in Port Arthur we shall have more to say in the tenth chapter.
Conditions among the Japanese were less favourable, since, on account of their rapid advance, sanitary measures could not be carried out as extensively as was desirable. The total number of men in the Japanese army carried away by diseases was no less than 21,802; 3,956 succumbed to beri-beri, 4,073 to typhoid fever, 1,804 to dysentery, and 11 to typhus fever.[[318]] All told, 95,572 cases of beri-beri were observed; at first the disease was very common, but later on, when barley was added to the rice, its prevalence decreased. The number of Japanese soldiers killed in battle was very large (47,387), and to these must be added 10,970 who died of wounds.
As to whether or not the war caused typhoid fever and dysentery to spread among the civil inhabitants of Manchuria, as was probably the case, we have no specific information; the appearance of other diseases among the civil inhabitants is improbable, since the troops would certainly have contracted them had they been prevalent.
No information has been given by either Russia or Japan as to whether the soldiers brought diseases back home with them. In Japan, according to the Year Book of Statistics,[[319]] the number of deaths was as follows:
| Typhoid. | Typhus. | Cholera. | Dysentery. | Beri-beri. | |
|---|---|---|---|---|---|
| 1903 | 4,585 | 9 | 140 | 7,172 | 10,783 |
| 1904 | 5,100 | 5 | 51 | 5,294 | 9,408 |
| 1905 | 6,291 | 10 | 34 | 8,763 | 11,703 |
| 1906 | 6,338 | 5 | 29 | 5,173 | 7,766 |
| 1907 | 5,974 | 6 | 1,702 | 5,872 | 8,767 |
| 1908 | 5,824 | 9 | 297 | 8,053 | 10,786 |
In order to prevent the transplantation of infectious diseases into Japan, very comprehensive measures of precaution were adopted by the Japanese military authorities, as was the case after the war with China. Infected soldiers, and soldiers suspected of being infected, were not allowed to join the transports; in order to find them out, three quarantine stations were established, one in Dairei (near Moji), a second in Ninoshima (near Ujina), and a third at Wadano Misaki (near Kobe). When the transports of troops reached their destination, the men were divided into groups of 60 and sent to disinfection establishments, where they were bathed and their effects were disinfected. The sick were committed to the hospital, and suspicious cases were quartered in barracks under observation. If infected men had been found on a ship, the entire ship, crew, and officers, were disinfected. The disinfection establishments received 828,376 men for examination; of these 429,962 were disinfected.[[320]]
5. The Occupation of Tripoli by the Italians (1911)
During the battles fought in connexion with the occupation of Tripoli by the Italians, infectious diseases were confined within narrow limits. According to Sforza, the army physician in Tripoli,[[321]] cholera broke out there in the second half of October 1911, reached its climax in November, and disappeared entirely in the second half of December. The disease was spread chiefly by dates, which had been infected by flies; it first appeared among the native beggars, then spread to the rest of the population, and finally to the Italian soldiers. The pestilence raged only in Tripoli, a fact which Sforza regards as a proof that it was not conveyed thither by the Italians; for had this been the case, cholera would have revealed its presence in Homs, Bengasi, Derna, and Tobruk, in which places thousands of soldiers disembarked, but not a single case of the disease was observed. Typhus fever is endemic in Tripoli; after the Italian occupation twenty cases of that disease were observed among the natives and ten cases among the soldiers. In order to prevent diseases from spreading to Italy, convalescents were not allowed to return home until there was absolutely no danger of their communicating the infection to other persons. The same measures of precaution were used in relation to relapsing fever.