The lesson which the experience of the Russian army of 1828 and 1829 taught the world of the mortal dangers of Bulgaria was lost on the British Government, which sent its own troops there in 1854, to be exposed to, and wither before, the same destructive influences. But at length sickness prevailed to such an extent, and death made such havoc, in the army in the East, that England's great sympathies were roused, and the Ministers' attention was drawn to the irresistible fact, that the strongest of Britain's soldiers were passing rapidly from the camp to the hospital, and from the hospital to the grave. Then a doubt occurred to the minds of the men in power, whether all was right in the Crimea, and whether something might not be done for the sanitary salvation of the army. They sent a commission, consisting of Dr. John Sutherland, one of the ablest sanitarians of the kingdom, Dr. Hector Gavin, and Robert Rawlinson, civil engineer, to the Black Sea, to inquire into the state of things there, to search out the causes of the sufferings of the army, and see if there might not be a remedy found and applied. At the same time, Miss Nightingale and a large corps of assistants, attendants, and nurses, women of station and culture and women of hire, went to that terrible scene of misery and death, to aid in any measures that might be devised to alleviate the condition of the men. Great abuses and negligence were found; and the causes of disease were manifest, manifold, and needless. But a reform was at once instituted; great changes were made in the general management of the camp and hospitals and in the condition of the soldiers. Disease began to diminish, the progress of mortality was arrested, and in the course of a few months the rate of death was as low as among men of the same ages at home.
This commission made a full report, when they returned, and described the state of things they found in the Crimea and on the shores of the Black Sea,—the camps, barracks, huts, tents, food, manner of life, and general sanitary condition of the troops, their terrible sufferings, and the means and ways of caring for the sick, the measures of reform which they had proposed and carried out, and their effects on the health of the men. This report was published by the Government.
Besides this commission, the Government sent Dr. Lyons, a surgeon and pathologist of great learning and acumen, to investigate the pathology or morbid condition of the army. According to his instructions, he spent four months in the Crimea and at the great hospitals on the Bosphorus. He examined and traced the course of disease and disturbance in the sick and wounded. He made very many thorough examinations after death, in order to determine the effects of vitiating influences upon the organization, and the condition of the textures and organs of the body in connection with the several kinds of disorders. Dr. Lyons's extremely instructive report was published by national authority as one of the Parliamentary folio volumes. After the war was over, Dr. W. Hanbury and Staff-Surgeon Matthew, under the direction of the Secretary of War, gathered, analyzed, and prepared the records of all the surgeons of the several corps of the Crimean army. To these they added a long and valuable treatise on the nature and character of the diseases, and their connection with the condition and habits of the men. These are published in two very thick folio volumes, and give a minute and almost daily history of the life, labors, exposures, privations, sufferings, sickness, and mortality of each regiment. These two works, of Dr. Lyons and Drs. Hanbury and Matthew, show the inseparable connection between the manner of living and the health, and demonstrate that the severe life of war, with its diminished creation of vital force, by imperfect and uncertain nutrition and excessive expenditure in exposures and labors, necessarily breaks down the constitution. It subjects the body to more abundant disorders, and especially to those of the depressive, adynamic type, which, from the want of the usual recuperative power, are more fatal than the diseases of civil life. These works may be considered generic as well as specific. They apply to and describe the sanitary condition and the pathological history of all armies engaged in hard and severe campaigns, as well as those of the Crimea. They should, therefore, be read by every Government that engages in or is forced into any war. They should be distributed to and thoroughly understood by every commander who directs the army, and every surgeon who superintends the sanitary condition of, and manages the sickness among, the men; and happy will it be for those soldiers whose military and sanitary directors avail themselves of the instructions contained in these volumes.
There are several other works on the Crimean War, by surgeons and other officers, written mainly to give a knowledge of the general facts of those campaigns, but all incidentally corroborating and explaining the statements in the Government Reports, in respect to the health and sufferings of the British and French armies. In this view, Dr. Bryce's book, "England and France before Sebastopol," and M. Baudens's and M. Scrive's medical works in French, are worthy of great attention and confidence.
The most important and valuable work, in this connection, is the Report of the British Commission appointed in May, 1854, "to inquire into the regulations affecting the sanitary condition of the British army, the organization of the military hospitals, and the treatment of the sick and wounded." This commission included some of the ablest and most learned physicians and surgeons in the civil and military service, some of the most accomplished statisticians, sanitarians, army-officers, and statesmen in the United Kingdom. They were authorized to inquire into the habits and duties, the moral and sanitary condition of the army, the amount and kinds of sickness, the causes and frequency of death, and the means of improvement. This commission sat for a long time in London. They called before them fifty-three witnesses, among whom were Sir Benjamin Brodie, the leading surgeon of England, Dr. Andrew Smith, Director-General of the Medical Department of the Army, Thomas Alexander, Inspector-General of Hospitals, Major-General Airey, Quartermaster-General, Dr. John Sutherland, late Crimean Commissioner, and one of the leading authorities of Great Britain in all sanitary matters, Dr. William Fair, the chief and master-spirit of the Registry-Office, and the highest authority in vital statistics, Colonel Sir Alexander Tulloch, author of the elaborate and valuable reports on the mortality in the British army, Francis G. P. Neison, author of "Contributions to Vital Statistics," Miss Nightingale, and others, surgeons, officers, purveyors, engineers, soldiers, and medical and sanitary scholars.
The commission put forth 10,070 interrogatories relating to everything connected with the army, the persons and the matériel, to officers, surgeons, physicians, health-officers, soldiers, nurses, cooks, clothing, food, cooking, barracks, tents, huts, hospitals, duties, labors, exposures, and privations, and their effects on health and life, in every climate, wherever British troops are stationed or serve, at home and abroad. The same inquiry was extended to the armies of other nations, French, Turkish, Russian, etc. To these questions the witnesses returned answers, and statements of facts and opinions, all carefully prepared, and some of great length, and elaborate calculations in respect to the whole military and sanitary science and practice of the age. A large part of the inquiry was directed to the Crimean army, whose condition had been, and was then, a matter of the most intense interest. Many of the witnesses had, in various ways, been connected with that war: they were familiar with its history, and their answers revealed much that had not before been known. The result of all this investigation is published in a folio volume of 607 pages, filled with facts and principles, the lamentable history of the past, painful descriptions of the present, and wise suggestions for the future management of the army; and the whole is worthy of the careful attention of all who, as projectors, leaders, or followers, have anything to do with the active operations of war.
The Crimean War has this remarkable interest, not that the suffering of the troops and their depreciation in effective power were greater than in many other wars, but that these happened in an age when the intelligence and philanthropy, and even the policy of the nation, demanded to know whether the vital depression and the loss of martial strength were as great as rumor reported, whether these were the necessary condition of war, and whether anything could be done to lessen them. By the investigations and reports of commissions, officers, and others, the internal history of this war is more completely revealed and better known than that of any other on record. It is placed on a hill, in the sight of all nations and governments, for their observation and warning, to be faithful to the laws of health in providing for, and in the use of, their armies, if they would obtain the most efficient service from them.
WANT OF SANITARY PREPARATIONS FOR WAR.
There are, and have been, faults—grievous, destructive, and costly faults—in all connected with armies, from the Governments at the head, down through all grades of officers, to the men in the ranks: they are faults of theory and faults of practice,—of plan in those who direct, and of self-management in those whose whole duty is to obey. The root of this is the failure to fully understand and count the cost, and to prepare to meet it as men generally do in the management of their common affairs. In civil life, when prudent men intend to effect any purpose by the aid of motive power, whether of water, steam, horse, or other kind, they carefully consider the means of generating that power, and the best and safest ways of applying and expending it. They include this in their plans, and make provision accordingly. Precisely determining the extent of the purpose they design to effect, and the amount of force that is and will be needed, they make their arrangements to provide or generate and maintain so much as long as they intend to do the work. During the whole process, they carefully guard and treasure it up and allow none to be wasted or applied to any other than the appointed purpose. But in the use and management of the vital machines, the human bodies, by which the purposes of war are to be accomplished, nations are less wise. There are few, perhaps no records of any Government, which, in creating, maintaining and operating with an army, has, at and during the same time, created and established the never-failing means of keeping the machinery of war in the best working order, by sustaining the health and force of the men in unfailing fulness.
War is carried on by a partnership between the Government and soldiers, to which the Government contributes money and directing skill, and assumes the responsibility of management, and the soldiers contribute their vital force. In the operation of this joint concern, both the money of the nation and the lives of the men are put at risk. Although, by the terms of the contract, the Government is presumed to expend its money and the soldiers' vital force to the extent that may be necessary to effect the objects of the association, it has no right to do this for any other purpose or on any other condition. It may send the men to battle, where they may lose in wounds or in death a part or all that they have contributed; but it has no right, by any negligence or folly on its own part or in its agents, to expend any of the soldiers' health or strength in hunger, nakedness, foul air, miasma, or disease. There is a received glory attached to wounds, and even to death, received in a struggle with the enemies of one's country, and this is offered as a part of the compensation to the warrior for the risk that he runs; but there is no glory in sickness or death from typhus, cholera, or dysentery, and no compensation of this kind comes to those who suffer or perish from these, in camp or military hospital.