For a successful battle against war-pestilences, it is a fortunate coincidence that the civil as well as the military authorities are equally interested in their prevention. Every military leader knows how important it is for the soldiers to keep healthy, since their efficiency is otherwise seriously impaired. It is not our task to describe the particular measures that are to be adopted; the manuals of military sanitation give us accurate information regarding these matters. We merely mention the fact that it is of great value and importance to have physicians, who are well acquainted with hygienic problems, make a preliminary examination of sanitary conditions in the territory through which the soldiers will be required to pass in order to reach the scene of hostilities.

Very great difficulties, to be sure, confront the efforts made in war times to prevent the outbreak of infectious diseases. If the struggle is carried on in an infected region, the troops are often compelled to seek shelter in infected houses; thus during the battles of Orléans and Le Mans in the Franco-German War the troops, in order to protect themselves against the severe winter cold, had to live in houses which small-pox patients had shortly before occupied or were actually occupying at the time. Circumstances frequently arise which render impossible the adoption of the most effective measure calculated to prevent the dissemination of a pestilence, that is, the isolation of infected divisions of troops; one can readily imagine how difficult this would be in the case of an army re-forming after a lost battle. Furthermore, even if one of the belligerent armies is doing all it can to prevent diseases from spreading, its efforts must be seriously handicapped if the enemy’s army does not include an equally diligent sanitary corps and does not devote the same amount of energy to the prevention of the outbreak and dissemination of infectious diseases. For even if a sanitary corps is successful in warding off a reaction upon its own troops, nevertheless this reaction is sure to take place with respect to the civil inhabitants of the country in which the war is waged.

During a war, the civil authorities must also do their part in preventing diseases from spreading to the civil population. The local administrations of a region in which fighting is going on are powerless. The generals care very little whether or not a city or village in the enemy’s country is infected by their troops, whom they quarter in whatever house or place best suits their purpose. On the other hand, the communities in which military prisons are located are confronted with a very difficult problem, since these prisons, if infected men are confined in them, easily develop into centres of infection; this fact was observed a hundred times in the year 1870. If a disease breaks out in a community in consequence of the fact that a military prison has been established there, in my opinion it is incumbent on the central government of the country to support the local authorities in their efforts to check the disease, and to give them financial help as well as scientific advice. Unfortunately, it is not to be denied that, in many small cities and in almost all rural communities, absolutely no provision is made for the isolation of persons suffering from infectious diseases; the authorities justify themselves with the reflection that in case of emergency barracks can quickly be erected for the purpose, but at the same time they fail to remember that working-men are not always available in the storm and stress of war times, that building materials in the general scarcity of supplies cannot always be procured with sufficient promptitude, and that pestilences, if the isolation of the first cases is delayed, usually spread with great rapidity.

In future wars we must expect the military authorities to do all they can, just as soon as the prisoners are taken, to segregate as carefully as possible all known and suspected cases of infectious diseases. The difficulties confronting the military authorities, when it is necessary to remove large numbers of prisoners with all possible dispatch away from the scene of the war, are, to be sure, very great.

Finally, we must also call attention to the danger to which the civil inhabitants of a country are exposed, when the soldiers return home after the termination of a campaign in an infected region. It must be demanded under all circumstances that divisions of troops among whom infectious diseases have made their appearance, before returning from the enemy’s country, shall be subjected to a medical examination, isolated, and disinfected, just as was done on such a large scale, for example, by the Japanese after the wars with China and Russia. This also applies to all other persons who have had anything to do with infected divisions, particularly to teamsters.

All preparations designed to prevent the outbreak and dissemination of infectious diseases must be made in times of peace; barracks and lazarets must be erected, physicians who are well acquainted with methods of hygienic investigation must be available, and an adequate number of nurses and sick-attendants must be prepared for immediate service at the very first appearance of an infectious disease. For the military authorities, who can scarcely perform all the duties that the beginning of a war imposes upon them, it will facilitate matters greatly if in future campaigns the Red Cross devotes its attention, not only to the care of the wounded, but also, on a larger scale than it has heretofore, to the prevention of the outbreak and dissemination of war-pestilences.

INDEX

GENERAL APPENDIX
PUBLICATIONS OF THE DIVISION OF ECONOMICS AND HISTORY

The Conference which met at Berne in 1911, under the auspices of the Division of Economics and History of the Carnegie Endowment for International Peace, appointed three Commissions to draft the questions and problems to be dealt with by competent authorities in all countries. The first Commission was entrusted with The Economic and Historical Causes and Effects of War; the second with Armaments in Time of Peace; the third with The Unifying Influences in International Life. Subsequently the suggestions of the three Commissions were considered and approved by the entire Conference.