The history of war has always been a history of epidemics. The fact that in an army men are crowded together makes it easy for all communicable diseases, once introduced, to spread with great rapidity. And because soldiers are always associated with the civilian population, it means that such diseases are readily communicated from the army to the civilians, and from the civilians to the army. It is therefore apparent that during a war, disease, unless quickly checked, may run like wild fire through a country, and be disseminated far and wide by soldiers returning to and from their own homes, or other distant places while on leave.
Advances made in our knowledge of how diseases are spread and controlled, particularly through recent studies in bacteriology and immunity, have made it possible to keep communicable diseases in absolute subjection. The marvel of the age is the lack of epidemic disease in the army to-day. This is particularly striking in view of our experiences in other recent wars. In the Franco-Prussian war of 1870, for instance, smallpox was fanned into a great flame, and there resulted the largest smallpox epidemic in 80 years. It is interesting to note that the medical authorities in Paris, in the first year and a half of the present war, vaccinated over 25,000 strangers passing through Paris; they are taking no chances with another outbreak of smallpox.
In the Boer War the British losses through typhoid fever alone were 8,000 against 7,700 killed by bullets, shells and other agencies.
The British army of nearly five million men in France and England to-day, has so little typhoid that it is practically a negligible quantity, and this holds with other communicable diseases. There must be some basic reason for this freedom from contagious diseases, for we know that such freedom does not come by accident.
No attempt will be made to deal with those auxiliary forces employed to keep the men physically and mentally fit. Such things as the provision of an adequate and wholesome food supply; proper clothing; amusements, such as games, competitions, horse shows, cinemas, variety shows; and Y.M.C.A.'s are all an integral part of the machinery necessary to keep an army in the field well and happy.
Only an attempt will be made to discuss the principles underlying the prevention of disease in use in the British army in France,—principles with which the average layman is comparatively unacquainted.
In the first place, it is well to realize that in the temperate climate of Europe, the vast majority of communicable diseases of importance from the military standpoint are contracted largely from three sources:
Group 1. From throat and nose secretions; e.g., diphtheria, measles, etc.
Group 2. From biting insects; e.g., malaria, typhus fever, plague, etc.
Group 3. Through intestinal secretions; e.g., typhoid fever, cholera, dysentery, etc.