In November all the soldiers were given was horse-meat; only the sick received canned meat. The supply of food in the possession of private individuals was exhausted, while garlic and vegetables had given out altogether.
On September 19 the Japanese captured the redoubts controlling one of the aqueducts that supplied Port Arthur with water; there was however another aqueduct, and, furthermore, wells were bored and a plant for distilling seawater was put into operation. The statement of the Russian General Staff that there was at no time a serious scarcity of water is not confirmed in Olga von Baumgarten’s diary, which frequently refers in plaintive terms to the lack of drinking-water in the lazarets.[[354]]
During the summer the condition of health among the Russian troops was comparatively good;[[355]] on August 26 there were 132 officers and 5,661 men in the lazarets. In the first part of October typhoid fever broke out in Port Arthur, where it was endemic, and before long an epidemic of such severity was raging in the city that it was difficult to find places in which to shelter the patients. There were also a great many cases of dysentery. Owing to the lack of preserved meat and vegetables, scurvy also made its appearance; the first cases of the disease were observed early in October. In the latter part of that month there were in the lazarets 450 typhoid-fever patients, 855 dysentery patients, and 167 scurvy patients. In addition to these diseases, cases of night-blindness (inability to see after dusk) were observed; the latter disease is quite common among Russian country-people, being caused by bad nourishment.
In December the garrison was completely exhausted. Scurvy had become more and more widespread, and between the fourteenth and twenty-seventh of that month 71 officers and 1,790 men had been committed to the lazarets. On the day of the surrender (January 2, 1905) the number of men in the Russian garrison was 32,400, and of these 6,458 were lying sick or wounded in the lazarets.[[356]] Of the remaining 25,942 men, 13,207 were incapacitated; thus the number of healthy men (besides 2,193 marines) in the garrison at the time of the surrender was only 12,735. Regarding the loss of life during the siege we find no information in the report of the General Staff. The number of soldiers in the city (excluding the officers and officials) was 41,780 at the beginning and 32,400 at the end of the siege. No further information regarding the condition of health among the civil inhabitants of Port Arthur is obtainable.
CONCLUSION
The history of war-pestilences has shown how severely belligerent armies are attacked by infectious diseases, how seriously their operations are hampered by them, and what loss of life such diseases cause by spreading to non-combatants. If we start from the time when more or less accurate descriptions enable us to determine the nature of the epidemics, we find that plague and typhus fever were the two diseases which, until a few decades ago, most commonly attacked the soldiers; the latter disease, which made its appearance in almost every war that was waged between the beginning of the sixteenth and the middle of the nineteenth century, consequently acquired the name ‘war-plague’.
For a long time nobody knew just how to combat these pestilences, and nowhere were rational measures adopted aiming to prevent them from spreading. We have seen the bitter truth of this statement in connexion with the endless Napoleonic wars. One reason for the neglect of preventive measures was the belief that these pestilences broke out spontaneously when large numbers were crowded together under miserable living conditions. The physicians of that time, in their efforts to explain the sudden appearance of these pestilences, arrived at the conclusion that they were autochthonic. But modern medical science, realizing its limitations, contents itself with the hypothesis that the original cause of these diseases is not to be ascertained, and with the knowledge that the infective agents in the case of almost all of them have been discovered, and that an outbreak of any infectious disease in any specific locality signifies that the germ of that disease must in some way have been deposited there. It was precisely the belief in the spontaneous origination of pestilences that led people to neglect watching for and isolating, with all possible dispatch, the first cases—a measure which is to-day looked upon as the most important means of preventing the dissemination of a disease.
The belief in the autochthonic origin of diseases continued to prevail until the first half of the nineteenth century. Hecker upheld it in a discussion of the plague-epidemic that occurred during the Russo-Turkish War of 1769–70; he believed that the intermittent fever prevalent in the Danube countries passed over into putrid fever, with or without petechiae, that carbuncles and buboes gradually developed, and that putrid fever was thus converted into bubonic plague. ‘It is therefore in all probability true’, says Hecker, ‘that the outbreak of plague in the Russian army in the year 1770, as well as in the year 1828, was not caused by direct infection from the Turkish troops, but was merely an independent development from intermittent fever and spotted fever.’
Recent investigations in the field of medicine turn over to the other sciences all questions regarding ultimate causes, and confine themselves to what is actually observed. We know that the agents responsible for infectious diseases are specific minute organisms which must be present in the system to produce the disease in question, and that these micro-organisms are conveyed from place to place by infected persons, by intermediaries, on articles to which they have attached themselves, in contaminated food, in drinking-water, and in many other ways. Investigators have studied the conditions in which these infective agents live and the manner in which they are disseminated, they have discovered methods of determining the nature of the disease in a very short time, and they have come to recognize the danger of coming in contact with germ-bearers, that is, with persons, healthy or convalescent, who have these micro-organisms in their systems without being themselves sick. Medical science is now endeavouring, by means of systematic procedure and splendid organization, to guard soldiers against the danger of infection; good drinking-water is provided, the men and the rooms in which they live are kept clean, persons suffering from infectious diseases are isolated, all rooms and articles used by patients are disinfected, infected divisions of troops are quartered by themselves, germ-bearers are watched for and discovered, &c. The success of such measures is well known. The knowledge gained and profited by in times of peace is also applied in times of war, and to-day we are able to confine pestilences within much narrower limits than was formerly possible. In order to do this, however, we must have, in addition to an efficient system of transporting and feeding troops, physicians who are well informed in regard to hygiene and bacteriology.
As early as the eighteenth century, successful efforts were made to prevent, by means of energetic measures, the reappearance of plague in Europe; the Russo-Turkish War of 1828–9 was the last war in which it broke out. On the other hand, typhus fever continued to be the Nemesis of belligerent armies, while a new infectious disease, cholera, entered upon the scene and played a very important rôle in the Crimean War, and a by no means minor rôle in the war of 1866. Along with these diseases, typhoid fever advanced into the foreground about the middle of the last century, and it soon turned out to be one of the most dangerous diseases that occur among soldiers. This appearance of typhoid fever has led some to think that the disease has prevailed extensively only in comparatively recent times. Hirsch, however, ably defends the opposite view; he maintains that typhoid fever was in many instances confused with the febres pestilentes, malignae, putridae, and nervosae, with the mucous fevers, bilious fevers, putrid fevers, &c. In discussing the typhus-fever epidemics that occurred in the course of the Napoleonic wars, we have several times called attention to the fact that typhoid fever probably broke out in the form of epidemics; but it could be diagnosed with certainty only after post-mortem examinations began to be more frequent. At all events, typhoid fever is to-day prevalent all over the world, and there is always danger that field-armies will be infected with it, either in their own land or in the land of the enemy. All the wars of the last few decades have clearly demonstrated this fact.