Chapter VIII: Part III (4)

"Of 115,000 Russians who invaded Turkey in 1828 and 1829, only 10,000 or 15,000 ever repassed the Pruth. The rest died there of intermittent fevers, dysenteries, and plague." "From May, 1828, to February, 1829, 210,108 patients were admitted into the general and regimental hospitals." "In October, 1828, 20,000 entered the general hospitals." "The sickness was very fatal." "More than a quarter of the fever-patients died." "5,509 entered the hospitals, and of these, 3,959 died in August, 1829, and only 614 ultimately recovered." "At Brailow the plague attacked 1,200 and destroyed 774." "Dysentery was equally fatal." "In the march across the Balkan, 1,000 men died of diarrhoea, fever, and scurvy." "In Bulgaria, during July, 37,000 men were taken sick." "At Adrianople a vast barrack was taken for a hospital, and in three days 1,616 patients were admitted. On the first of September there were 3,666, and on the 15th, 4,646 patients in the house. This was one-quarter of all the disposable force at that station." "In October, 1,300 died of dysentery; and at the end of the month there were 4,700 in the hospitals." "In the whole army the loss to the Russians in the year 1829 was at least 60,000 men."[21]

CRIMEAN WAR.

In 1854, twenty-five years after this fatal experience of the Russian army in Bulgaria, the British Government sent an army to the same province, where the men were exposed to the same diseases and suffered a similar depreciation of vital force in sickness and death. For two years and more they struggled with these destructive influences in their own camps, in Bulgaria and the Crimea, with the usual result of such exposures in waste of life. From April 10, 1854, to June 30, 1856, 82,901 British soldiers were sent to the Black Sea and its coasts; and through these twenty-six and two-thirds months the British army had an average of 34,559 men engaged in that "War in the East" with Russia. From these there were furnished to the general and regimental, the stationary and movable hospitals 218,952 cases: 24,084, or 11 per cent, of these patients were wounded or injured in battle, and 194,868, or 89 per cent, suffered from the diseases of the camp. This is equal to an annual average of two and a half attacks of sickness for each man. The published reports give an analysis of only 162,123 of these cases of disease. Of these, 110,673, or 68 per cent., were of the zymotic class,--fevers, dysenteries, scurvy, etc., which are generally supposed to be due to exposure and privation, and other causes which are subject to human control. During the two years ending with March, 1856, 16,224 died of diseases, of which 14,476 were of the zymotic or preventable class, 2,755 were killed in battle, and 2,019 died of wounds and injuries received in battle. The annual rate of mortality, from all diseases, was 23 per cent; from zymotic diseases, 21 per cent.; from battle, 6.9 per cent. The rate of sickness and mortality varied exceedingly in different months. In April, May, and June, 1854, the deaths were at the annual rate of 8.7 per 1,000; in July, 159 per 1,000; in August and September, 310 per 1,000; in December, this rate again rose and reached 679 per 1,000; and in January, 1855, owing to the great exposures, hardships, and privations in the siege, and the very imperfect means of sustenance and protection, the mortality increased to the enormous rate of 1,142 per 1,000, so that, if it had continued unabated, it would have destroyed the whole army in ten and a half months.[22]

AMERICAN ARMY, 1812 TO 1814.

We need not go abroad to find proofs of the waste of life in military camps. Our own army, in the war with Great Britain in 1812-14, suffered, as the European armies have done, by sickness and death, far beyond men in civil occupations. There are no comprehensive reports, published by the Government, of the sanitary condition and history of the army on the Northern frontier during that war. But the partial and fragmentary statements of Dr. Mann, in his "Medical Sketches," and the occasional and apparently incidental allusions to the diseases and deaths by the commanding officers, in their letters and despatches to the Secretary of War, show that sickness was sometimes fearfully prevalent and fatal among our soldiers. Dr. Mann says: "One regiment on the frontier, at one time, counted 900 strong, but was reduced, by a total want of a good police, to less than 200 fit for duty." "At one period more than 340 were in the hospitals, and, in addition to this, a large number were reported sick in camp."[23] "The aggregate of the army at Fort George and its dependencies was about 5,000. From an estimate of the number sick in the general and regimental hospitals, it was my persuasion that but little more than half of the army was capable of duty, at one period, during the summer months"[24] of 1813. "During the month of August more than one-third of the soldiers were on the sick-reports."[25] Dr. Mann quotes Dr. Lovell, another army-surgeon, who says, in the autumn of 1813: "A morning report, now before me, gives 75 sick, out of a corps of 160. The several regiments of the army, in their reports, exhibit a proportional number unfit for duty."[26] Dr. Mann states that "the troops at Burlington, Vt., in the winter of 1812-13, did not number over 1,600, and the deaths did not exceed 200, from the last of November to the last of February."[27] But Dr. Gallup says: "The whole number of deaths is said to be not less than 700 to 800 in four months," and "the number of soldiers stationed at this encampment [Burlington] was about 2,500 to 2,800."[28] According to Dr. Mann's statement, the mortality was at the annual rate of 50 per cent.; and according to that of Dr. Gallup, it was at the rate of 75 to 96 per cent. This is nearly equal to the severest mortality in the Crimea.

General William H. Harrison, writing to the Secretary of War from the borders of Lake Erie, Aug. 29, 1813, says: "You can form some estimate of the deadly effects of the immense body of stagnant water with which the vicinity of the lake abounds, from the state of the troops at Sandusky. Upwards of 90 are this morning reported sick, out of about 220." This is a rate of over 40 per cent. "Those at Fort Meigs are not much better."[29]

General Wilkinson wrote from Fort George, Sept. 16, 1813: "We count, on paper, 4,600, and could show 3,400 combatants"; that is, 25 per cent, and more are sick. "The enemy, from the best information we have, have about 3,000 on paper, of whom 1,400," or 46.6 per cent., "are sick."[30]

MEXICAN WAR.

There was a similar waste of life among our troops in the Mexican War. There is no published record of the number of the sick, nor of their diseases. But the letters of General Scott and General Taylor to the Secretary of War show that the loss of effective force in our army was at times very great by sickness in that war.

General Scott wrote:--

"_Puebla_, July 25, 1847.

"May 30, the number of sick here was 1,017, of effectives 5,820."

"Since the arrival of General Pillow, we have effectives (rank and
file) 8,061, sick 2,215, beside 87 officers under the latter
head."[31]

Again:--

"_Mexico_, Dec. 5,1847.

"The force at Chapultepec fit for duty is only about 6,000, rank and
file; the number of sick, exclusive of officers, being 2,041."[32]

According to these statements, the proportions of the sick were 17.4 to 27.4 and 24.7 per cent of all in these corps at the times specified.

General Taylor wrote:--

"_Camp near Monterey_, July 27,1847.

"Great sickness and mortality have prevailed among the volunteer
troops in front of Saltillo."[33]

August 10th, he said, that "nearly 23 per cent, of the force present was disabled by disease."

The official reports show only the number that died, but make no distinction as to causes of death, except to separate the deaths from wounds received in battle from those from other causes.

During that war, 100,454 men were sent to Mexico from the United States. They were enlisted for various periods, but served, on an average, thirteen months and one day each, making a total of 109,104 years of military service rendered by our soldiers in that war. The total loss of these men was 1,549 killed in battle or died of wounds, 10,986 died from diseases, making 12,535 deaths. Besides these, 12,252 were discharged for disability. The mortality from disease was almost equal to the annual rate of 11 per cent., which is about ten times as great as that of men in ordinary civil life at home.

SICKNESS IN THE PRESENT UNION ARMY.

There are not as yet, and for a long time there cannot be, any full Government reports of the amount and kind of sickness in the present army of the United States. But the excellent reports of the inquiries of the Sanitary Commission give much important and trustworthy information in respect to these matters. Most of the encampments of all the corps have been examined by their inspectors; and their returns show, that the average number sick, during the seven months ending with February last, was, among the troops who were recruited in New England 74.6, among those from the Middle States 56.6, and, during six months ending with January, among those from the Western States 104.3, in 1,000 men. From an examination of 217 regiments, during two months ending the middle of February, the rate of sickness among the troops in the Eastern Sanitary Department was 74, in the Central Department, Western Virginia and Ohio, 90, and in the Western, 107, in 1,000 men. The average of all these regiments was 90 in 1,000. The highest rate in Eastern Virginia was 281 per 1,000, in the Fifth Vermont; and the lowest, 9, in the Seventh Massachusetts. In the Central Department the highest was 260, in the Forty-First Ohio; and the lowest, 17, in the Sixth Ohio. In the Western Department the highest was 340, in the Forty-Second Illinois; and the lowest, 15, in the Thirty-Sixth Illinois.

On the 22d of February, the number of men sick in each 1,000, in the several divisions of the Army of the Potomac, was ascertained to be,--

| Keyes's, | 30.3 | | Sedgwick's, | 32.0 | | Hooker's, | 43.7 | | McCall's | 44.4 | | Banks's, | 45.0 | | Porter's, | 46.4 | | Blenker's, | 47.7 | | McDowell's, | 48.2 | | Heintzelman's | 49.0 | | Franklin's | 54.1 | | Dix's, | 71.8 | | United States Regulars,| 76.0 | | Sumner's, | 77.5 | | Smiths's, | 81.6 | | Casey's | 87.6[34] |

Probably there has been more sickness in all the armies, as they have gone farther southward and the warm season has advanced. This would naturally be expected, and the fear is strengthened by the occasional reports in the newspapers. Still, taking the trustworthy reports herein given, it is manifest that our Union army is one of the healthiest on record; and yet their rate of sickness is from three to five times as great as that of civilians of their own ages at home. Unquestionably, this better condition of our men is due to the better intelligence of the age and of our people,--especially in respect to the dangers of the field and the necessity of proper provision on the part of the Government and of self-care on the part of the men,--to the wisdom, labors, and comprehensive watchfulness of the Sanitary Commission, and to the universal sympathy of the men and women of the land, who have given their souls, their hands, and their money to the work of lessening the discomforts and alleviating the sufferings of the Army of Freedom.

OTHER LIGHTER AND UNRECORDED SICKNESS.

The records and reports of the sickness in the army do not include all the depreciations and curtailments of life and strength among the soldiers, nor all the losses of effective force which the Government suffers through them, on account of disease and debility. These records contain, at best, only such ailments as are of sufficient importance to come under the observation of the surgeon. But there are manifold lighter physical disturbances, which, though they neither prostrate the patient, nor even cause him to go to the hospital, yet none the less certainly unfit him for labor and duty. Of the regiment referred to by Dr. Mann, and already adduced in this article, in which 700 were unable to attend to duty, 340 were in the hospital under the surgeon's care, and 360 were ill in camp. It is probable that a similar, though smaller, discrepancy often exists between the surgeon's records and the absentees from parades, guard-duty, etc.

It is improbable, and even impossible, that complete records and reports should always be made of all who are sick and unfit for duty, or even of all who come under the surgeon's care. Sir John Hall, principal Medical Officer of the British army in the Crimea, says that there were "218,952 admissions into hospital."[35] "The general return, showing the primary admissions into the hospitals of the army in the East, from the 10th April, 1854, to the 30th June, 1856, gives only 162,123 cases of all kinds."[36] But another Government Report states the admissions to be 162,073.[37] Miss Nightingale says, "There was, at first, no system of registration for general hospitals, for all were burdened with work beyond their strength."[38] Dr. Mann says, that, in the War of 1812, "no sick-records were found in the hospital at Burlington," one of the largest depositories of the sick then in the country. "The hospital-records on the Niagara were under no order."[39] It could hardly have been otherwise. The regimental hospitals then, as frequently must be the case in war, were merely extemporized shelters, not conveniences. They were churches, houses, barns, shops, sheds, or any building that happened to be within reach, or huts, cabins, or tents suddenly created for the purpose. In these all the surgeons' time, energy, and resources were expended in making their patients comfortable, in defending them from cold and storm, or from suffering in their crowded rooms or shanties. They were obliged to devote all their strength to taking care of the present. They could take little account of the past, and were often unable to make any record for the future. They could not do this for those under their own immediate eye in the hospital; much less could they do it for those who remained in their tents, and needed little or no medical attention, but only rest. Moreover, the exposures and labors of the campaign sometimes diminish the number and force of the surgeons as well as of the men, and reduce their strength at the very moment when the greatest demand is made for their exertions. Dr. Mann says, "The sick in the hospital were between six and seven hundred, and there were only three surgeons present for duty." "Of seven surgeons attached to the hospital department, one died, three were absent by reason of indisposition, and the other three were sick."[40] Fifty-four surgeons died in the Russian army in Turkey in the summer of 1828. "At Brailow, the pestilence spared neither surgeons nor nurses."[41] Sir John Hall says, "The medical officers got sick, a great number went away, and we were embarrassed." "Thirty per cent. were sometimes sick and absent" from their posts in the Crimea.[42] Seventy surgeons died in the French army in the same war. It is not reasonable, then, to suppose that all or nearly all the cases of sickness, whether in hospital or in camp, can be recorded, especially at times when they are the most abundant.

Nor do the cases of sickness of every sort, grave and light, recorded and unrecorded, include all the depressions of vital energy and all the suspensions and loss of effective force in the army. Whenever any general cause of depression weighs upon a body of men, as fatigue, cold, storm, privation of food, or malaria, it vitiates the power of all, in various degrees and with various results; the weak and susceptible are sickened, and all lose some force and are less able to labor and attend to duty. No account is taken, none can be taken, of this discount of the general force of the army; yet it is none the less a loss of strength, and an impediment to the execution of the purposes of the Government.

INVALIDING.

The loss of force by death, by sickness in hospital and camp, and by temporary depression, is not all that the army is subject to. Those who are laboring under consumption, asthma, epilepsy, insanity, and other incurable disorders, and those whose constitutions are broken, or withered and reduced below the standard of military requirement, are generally, and by some Governments always, discharged. These pass back to the general community, where they finally die. By this process the army is continually sifting out its worst lives, and at the same time it fills their places with healthy recruits. It thus keeps up its average of health and diminishes its rate of mortality; but the sum and the rates of sickness and mortality in the community are both thereby increased.

During the Crimean War, 17.34 per cent, were invalided and sent home from the British army, and 21 per cent, from the French army, as unable to do military service. By this means, 11,994[43] British and 65,069[44] French soldiers were lost to their Governments. The army of the United States, in the Mexican War, discharged and sent home 12,252 men, or 12 per cent, of the entire number engaged in that war, on account of disability.

The causes of this exhaustion of personal force are manifold and various, and so generally present that the number and proportion of those who are thus hopelessly reduced below the degree of efficient military usefulness, in the British army, has been determined by observation, and the Government calculates the rate of the loss which will happen in this way, at any period of service. Out of 10,000 men enlisted in their twenty-first year, 718 will be invalided during the first quinquennial period, or before they pass their twenty-fifth year, 539 in the second, 673 in the third, and 854 in the fourth,--making 2,784, or more than one-quarter of the whole, discharged for disability or chronic ailment, before they complete their twenty years of military service and their forty years of life.

It is further to be considered, that, during these twenty years, the numbers are diminishing by death, and thus the ratio of enfeebled and invalided is increased. Out of 10,000 soldiers who survive and remain in the army in each successive quinquennial period, 768 will be invalided in the first, 680 in the second, 1,023 in the third, and 1,674 in the fourth. In the first year the ratio is 181, in the fifth 129, in the tenth 165, in the fifteenth 276, and in the twentieth 411, among 10,000 surviving and remaining.

The depressing and exhaustive force of military life on the soldiers is gradually accumulative, or the power of resistance gradually wastes, from the beginning to the end of service. There is an apparent exception to this law in the fact, that, in the British army, the ratio of those who were invalided was 181 in 10,000, but diminished, in the second, third, and fourth years, to 129 in the fifth and sixth, then again rose, through all the succeeding years, to 411 in the twentieth. The experience of the British army, in this respect, is corroborated by that of ours in the Mexican War. From the old standing army 502, from the additional force recently enlisted 548, and from the volunteers 1,178, in 10,000 of each, were discharged on account of disability. Some part of this great difference between the regulars and volunteers is doubtless due to the well-known fact, that the latter were originally enlisted, in part at least, for domestic trainings, and not for the actual service of war, and therefore were examined with less scrutiny, and included more of the weaker constitutions.

The Sanitary Commission, after inspecting two hundred and seventeen regiments of the present army of the United States, and comparing the several corps with each other in respect of health, came to a similar conclusion. They found that the twenty-four regiments which had the least sickness had been in service one hundred and forty days on an average, and the twenty-four regiments which had the most sickness had been in the field only one hundred and eleven days. The Actuary adds, in explanation,--"The difference between the sickness of the older and newer regiments is probably attributable, in part, to the constant weeding out of the sickly by discharges from the service. The fact is notorious, that medical inspection of recruits, on enlistment, has been, as a rule, most imperfectly executed; and the city of Washington is constantly thronged with invalids awaiting their discharge-papers, who at the time of their enlistment were physically unfit for service."[45] In addition to this, it must be remembered, that, although all recruits are apparently perfect in form and free from disease when they enter the army, yet there may be differences in constitutional force, which cannot be detected by the most careful examiners. Some have more and some have less power of endurance. But the military burden and the work of war are arranged and determined for the strongest, and, of course, break down the weak, who retire in disability or sink in death.

GENERAL VITAL DEPRESSION

Two causes of depression operate, to a considerable degree in peace and to a very great degree in war, on the soldier, and reduce and sicken him more than the civilian. His vital force is not so well sustained by never-failing supplies of nutritious and digestible food and regular nightly sleep, and his powers are more exhausted in hardships and exposures, in excessive labors and want of due rest and protection against cold and heat, storms and rains. Consequently the army suffers mostly from diseases of depression,--those of the typhoid, adynamic, and scorbutic types. McGrigor says, that, in the British army in the Peninsula, of 176,007 cases treated and recorded by the surgeons, 68,894 were fevers, 23,203 diseases of the bowels, 12,167 ulcers, and 4,027 diseases of the lungs.[46] In the British hospitals in the Crimean War, 39 per cent. were cholera, dysentery, and diarrhoea, 19 per cent. fevers, 1.2 per cent. scurvy, 8 per cent. diseases of the lungs, 8 per cent. diseases of the skin, 3.3 per cent. rheumatism, 2.5 per cent. diseases of the brain and nervous system, 1.4 per cent. frost-bite or mortification produced by low vitality and chills, 13, or one in 12,000, had sunstroke, 257 had the itch, and 68 per cent. of all were of the zymotic class,[47] which are considered as principally due to privation, exposure, and personal neglect. The deaths from these classes of causes were in a somewhat similar proportion to the mortality from all stated causes,--being 58 per cent. from cholera, dysentery, and diarrhoea, and 1 per cent. from all other disorders of the digestive organs, 19 per cent. from fevers, 3.6 per cent. from diseases of the lungs, 1.3 per cent. from rheumatism, 1.3 per cent. from diseases of the brain and nervous system, and 79 per cent. from those of the zymotic class. The same classes of disease, with a much larger proportion of typhoid, pneumonia, prostrated and destroyed many in the American army in the War of 1812.

In paper No. 40, p. 54, of the Sanitary Commission, is a report of the diseases that occurred in forty-nine regiments, while under inspection about forty days each, between July and October, 1861. 27,526 cases were reported; of these 67 per cent. were zymotic, 41 per cent. diseases of the digestive organs, 22 per cent. fevers 7 per cent. diseases of the lungs, 5 per cent. diseases of the brain. Among males of the army-ages the proportions of deaths from these classes of causes to those from all causes were, in Massachusetts, in 1859, zymotic 15 per cent., diseases of digestive organs 3.6 per cent., of lungs 50 per cent., fevers 9 per cent., diseases of brain 4.6 per cent[48]. According to the mortality-statistics of the seventh census of the United States, of the males between the ages of twenty and fifty, in Maryland, Virginia, North Carolina, South Carolina, and Georgia, whose deaths in the year ending June 1st, 1850, and their causes, were ascertained and reported by the marshals, 34.3 per cent. died of zymotic diseases, 8 per cent. of all the diseases of the digestive organs, 30.8 per cent. of diseases of the respiratory organs, 24.4 per cent. of fevers, and 5.7 per cent. of disorders of the brain and nervous system. In England and Wales, in 1858, these proportions were, zymotic 14 per cent., fevers 8 per cent., diseases of digestive organs 7.9 per cent., of lungs 8 per cent., and of the brain 7 per cent[49].

If, however, we analyze the returns of mortality in civil life, and distinguish those of the poor and neglected dwellers in the crowded and filthy lanes and alleys of cities, whose animal forces are not well developed, or are reduced by insufficient and uncertain nutrition, by poor food or bad cookery, by foul air within and stenchy atmosphere without, by imperfect protection of house and clothing, we shall find the same diseases there as in the army. Wherever the vital forces are depressed, there these diseases of low vitality happen most frequently and are most fatal.

Volumes of other facts and statements might be quoted to show that military service is exhaustive of vital force more than the pursuits of civil life. It is so even in time of peace, and it is remarkably so in time of war. Comparing the English statements of the mortality in the army with the calculations of the expectation of life in the general community, the difference is at once manifest.

Of 10,000 men at the age of twenty, there will die before they complete their fortieth year,--

British army in time of peace, 3,058 England and Wales, English Life-Table, 1,853 According to tables of Amicable and Equitable Life-Insurance Companies, 1,972 New England and New York, according to the tables of the New-England Mutual Life-Insurance Company, 1,721

DANGERS IN LAND-BATTLES.

This large amount of disease and mortality in the army arises not from the battle-field, but belongs to the camp, the tent, the barrack, the cantonment; and it is as certain, though not so great, in time of peace, when no harm is inflicted by the instruments of destruction, as in time of war. The battle, which is the world's terror, is comparatively harmless. The official histories of the deadly struggles of armies show that they are not so wasteful of life as is generally supposed. Mr. William Barwick Hodge examined the records and despatches in the War-Office in London, and from these and other sources prepared an exceedingly valuable and instructive paper on "The Mortality arising from Military Operations," which was read before the London Statistical Society, and printed in the nineteenth volume of the Society's journal. Some of the tables will be as interesting to Americans as to Englishmen. On the following page is a tabular view, taken from this work, of the casualties in nineteen battles fought by the British armies with those of other nations.

TABLE 1.--NINETEEN LAND-BATTLES. BRITISH Casualties Killed in battle Officers --------------- and men Per 1000 Date. Battles. engaged Number engaged ------------------------ -------------------- ------ ---- ---- 1801, March 21, . . . . . Alexandria . . . . . 14,000 243 17.3 1806, July 4, . . . . . . Maida . . . . . . . 5,675 45 7.9 1808, August 21, . . . . Vimiciro . . . . . . 19,200 135 7. 1809, January 16, . . . . Corunna . . . . . . 16,700 158 9.4 " July 28, . . . . . Talavera . . . . . . 22,100 801 3.6 1810, September . . . . . Busaco . . . . . . . 27,800 106 3.9 1811, March 5, . . . . . Barrosa . . . . . . 5,230 202 38.6 " May 5, . . . . . . Fuentes de Onore . . 22,900 170 7.4 " " 16, . . . . . . Albuera . . . . . . 9,000 882 98. 1812, July 22, . . . . . Salamanca . . . . . 30,500 388 12.7 1813, June 21, . . . . . Vittoria . . . . . . 42,000 501 11.9 " July 25 to August 2 Pyrenees . . . . . . 30,000 559 18.6 " November 10, . . . Nivelle . . . . . . 47,600 277 5.7 1814, February 27, . . . Orthés . . . . . . . 27,000 210 7.7 " April 10, . . . . . Toulouse . . . . . . 26,800 312 11.6 1815, January 8, . . . . New Orleans . . . . 6,000 386 64.3 " June 16-18, . . . . Waterloo . . . . . . 49,900 2,126 42.6 1854, September 20, . . . Alma . . . . . . . . 26,800 353 13.1 " November 5, . . . . Inkerman . . . . . . 9,000 632 70.2 ------- ----- ---- 438,205 8,486 19.3 Estimated deaths among the wounded . . . . . . 4,894 Estimated casualties among the missing . . . . 1,137 ----- Total 14,517 33.1

TABLE 1.--NINETEEN LAND-BATTLES. (cont.)

BRITISH. (cont.) Deaths in battle Casualties (cont.) from wounds, and Wounded among the missing. Number. Per 1000 Number. Per 1000 Battles. engaged engaged -------------------- ----- ----- ----- ----- Alexandria . . . . . 1,193 85.2 393 28.1 Maida . . . . . . . 282 49.1 87 15.3 Vimiciro . . . . . . 534 27.7 215 11.2 Corunna . . . . . . 634 37.9 257 15.4 Talavera . . . . . . 3,913 17.7 1,455 65.8 Busaco . . . . . . . 500 18. 183 6.6 Barrosa . . . . . . 1,040 198.8 360 68.8 Fuentes de Onore . . 1,043 45.5 379 16.6 Albuera . . . . . . 2,672 296.6 1,358 151. Salamanca . . . . . 2,714 89. 770 25.2 Vittoria . . . . . . 2,807 66.8 890 21.2 Pyrenees . . . . . . 3,693 123.1 1,197 39.9 Nivelle . . . . . . 1,777 37.3 675 14.2 Orthés . . . . . . . 1,411 52.2 404 15. Toulouse . . . . . . 1,795 66.9 582 21.7 New Orleans . . . . 1,516 252.6 625 104.2 Waterloo . . . . . . 8,140 163.1 3,245 65. Alma . . . . . . . . 1,619 60.4 559 20.9 Inkerman . . . . . . 1,878 208.6 883 98.1 ----- ----- ----- ----- 39,161 89.3 14,517 33.

Total 91.9

TABLE 1.--NINETEEN LAND-BATTLES. (cont.)

BRITISH AND ALLIES. Officers Casualties. and men Battles. engaged. Number. Per 1000 -------------------- Alexandria . . . . . Maida . . . . . . . Vimiciro . . . . . . Corunna . . . . . . Talavera . . . . . . 56,000 6,268 112 Busaco . . . . . . . 57,000 1,300 23 Barrosa . . . . . . 14,500 1,610 111 Fuentes de Onore . . 35,200 1,469 42 Albuera . . . . . . 37,000 6,500 176 Salamanca . . . . . 54,200 4,964 92 Vittoria . . . . . . 95,800 4,829 50 Pyrenees . . . . . . 65,000 6,540 101 Nivelle . . . . . . 90,600 2,621 29 Orthés . . . . . . . 43,600 2,200 50 Toulouse . . . . . . 54,400 4,641 85 New Orleans . . . . Waterloo . . . . . . 230,600 36,590 159 Alma . . . . . . . . 55,000 3,545 64 Inkerman . . . . . . ------- ------ --- 888,900 83,077 92 Estimated casualties among the missing . . . . 3,787 ------ 86,864 98

Of those who were engaged in these nineteen battles one in 51.6, or 1.93 per cent., were killed. The deaths in consequence of the battles, including both those who died of wounds and those that died among the missing, were one in 30, or 3.3 per cent. of all who were in the fight. It is worth noticing here, that the British loss in the Battle of New Orleans was larger than in any other battle here adduced, except in that of Albuera, in Spain, with the French, in 1811.

In the British army, from 1793 to 1815, including twenty-one years of war, and excluding 1802, the year of peace, the number of officers varied from 3,576 in the first year to 13,248 in 1813, and the men varied from 74,500 in 1793 to 276,000 in 1813, making an annual average of 9,078 officers and 189,200 men, and equal to 199,727 officers and 4,168,500 men serving one year. During these twenty-one years of war, among the officers 920 were killed and 4,685 were wounded, and among the men 15,392 were killed and 65,393 were wounded. This is an annual average of deaths from battle of 460 officers and 369 men, and of wounded 2,340 officers and 1,580 men, among 100,000 of each class. Of the officers less than half of one per cent., or 1 in 217, were killed, and a little more than two per cent., or 1 in 42, were wounded; and among the men a little more than a third of one per cent., 1 in 271, were killed, and one and a half per cent., 1 in 63, wounded, in each year. The comparative danger to the two is, of death, 46 officers to 37 men, and of wounds, 234 officers to 158 men. A larger proportion of the officers than of the soldiers were killed and wounded; yet a larger proportion of the wounded officers recovered. This is attributed to the fact that the officers were injured by rifle-balls, being picked out by the marksmen, while the soldiers were injured by cannon- and musket-balls and shells, which inflict more deadly injuries.

DANGERS IN NAVAL BATTLES.

It may not be out of place here to show the dangers of naval warfare, which are discussed at length by Mr. Hodge, in a very elaborate paper in the eighteenth volume of the Statistical Society's journal. From one of his tables, containing a condensed statistical history of the English navy, through the wars with France, 1792-1815, the following facts are gathered.

During those wars, the British Parliament, in its several annual grants, voted 2,527,390 men for the navy. But the number actually in the service is estimated not to have exceeded 2,424,000 in all, or a constant average force of 110,180 men. Within this time these men fought five hundred and seventy-six naval battles, and they were exposed to storms, to shipwreck, and to fire, in every sea. In all these exposures, the records show that the loss of life was less than was suffered by the soldiers on the land. There were--

Killed in battle, officers, . . . 346 " " men, . . . 4,441 ------ Total, 4,787 Wounded, officers, . . . . 935 " men, . . . . 13,335 ------ Total, 14,270 Drowned and otherwise destroyed in battle, . . . . . . 449 Estimated deaths among the wounded, 1,427

Total destroyed by battle, . . . 6,663 Lost by shipwreck, accidental drowning

and by fire, . . . . . 13,621
Total deaths, from other causes than
disease, . . . . . . 20,284

Comparing the whole number of men in the naval service, during this period, with the mortality from causes incidental to the service, the average annual loss was--

Killed in battle, . . . . one in 506, or .197 per cent. Drowned and lost in battle, and died of wounds . . . . . one in 1,292, or .077 per cent. Wounded, . . . . . one in 169, or .588 per cent. Drowned and lost by shipwreck, fire, etc., otherwise than by battle, . one in 178, or .561 per cent. Total annual loss by battle and the special dangers of the sea, . . one in 119, or .836 per cent.

TABLE II.--BATTLES BETWEEN FLEETS OR SQUADRONS BRITISH. Guns Date. Place. Ships. Broadside. Men. 1782, April 12, West Indies 36 1,315 21,608 1794, June 1, English Channel 26 1,087 17,241 1795, March 14, Genoa 14 557 8,810 1797, February 14, Cape St. Vincent 15 620 9,508 " October 11, Camperdown 16 575 8,221 1798, August 1, Nile 14 507 7,985 1801, July 12, Algeziras 5 188 3,100 1805, July 22, Cape Finisterre 15 596 10,500 " October 21, Trafalgar 27 1,074 16,826 " November 4, Bay of Biscay 9 262 4,186 1806, February 6, San Domingo 7 257 4,094 1811, March 12, Lissa 4 59 886 " May 20, Madagascar 4 73 903 --- ----- ------- 192 7,170 113,863

TABLE II.--BATTLES BETWEEN FLEETS OR SQUADRONS (cont.) BRITISH. ENEMY. Killed. Wounded. Number. Per 1000. Number. Per 1000. West Indies 250 11 810 37 French. English Channel 290 16 858 47 do. Genoa 71 8 266 30 do. Cape St. Vincent 73 7 227 29 Spanish. Camperdown 203 24 622 75 Dutch. Nile 218 27 678 84 French. Algeziras 18 6 102 33 French and Spanish. Cape Finisterre 39 3 159 15 do. Trafalgar 449 26 1241 73 do. Bay of Biscay 24 5 111 26 French. San Domingo 74 1.8 264 64 do. Lissa 44 49 144 162 French and Italian. Madagascar 25 27 89 98 French. ---- ---- ---- ----- 1778 15.6 5571 48.9

TABLE III.--BATTLES BETWEEN BRITISH AND AMERICAN SHIPS.
BRITISH. Loss.
Guns
Duration broad-
Date. of action. Ship. side. Men. Killed. Wounded. Casualties.
Number. Per
H. M. 1000.

1812, August. 19, 1 55 Guerrière 24 244 15 63 78 320
" September 17, 43 Frolic 9 92 15 47 62 674
" October 25, 2 40 Macedonian 24 254 31 64 95 374
" December 20, 3 Java 24 379 22 102 124 379
1813, February 14, 25 Peacock 9 110 4 33 37 336
" June 1, 15 Shannon 25 306 24 59 83 271
" August 12, 45 Pelican 9 101 2 5 7 69
1814, August 27, 45 Reindeer 9 98 25 41 66 673
1815, January 15, 5 58 Endymion 24 319 11 14 25 78
--- ----- --- --- --- ---
157 1,903 149 428 577 303

TABLE III.--BATTLES BETWEEN BRITISH AND AMERICAN SHIPS. (cont.)
AMERICAN.
Guns.
Ship. Broadside. Men. Killed and wounded.
Number. Per 1000.
1812, August. 19, Constitution 28 460 20 43
" September 17, Wasp 9 135 16 119
" October 25, United States 28 474 6 13
" December 20, Constitution 28 480 34 71
1813, February 14, Hornet 10 162 5 31
" June 1, Chesapeake 25 376 146 389
" August 12, Argus 10 122 24 397
1814, August 27, Wasp 11 173 26 150
1815, January 15, President 28 465 105 226
--- ----- --- ---
177 2,847 382 133

Mr. Hodge's second table shows the conditions and casualties of thirteen battles between fleets and squadrons. This is condensed and quoted on the preceding page.

His third table includes thirty-five actions with single ships on each side, between the years 1793 and 1815. 8,542 men were engaged, and 483, or 56.5 per 1,000, were killed, and 1,230, or 144 per 1,000, wounded.

Twenty-six of these actions were with French ships, which are here omitted, and nine with American ships, which are shown in the second table on the preceding page.

There is a very remarkable difference in the loss which the British suffered in naval and in land battles:--

No. of Vessels. Killed. Wounded. Battles One in One in 13 Fleets.............. 64.0 20.4 35 Single ships........ 17.7 6.9 28 French single ships. 19.8 10.6 9 American do. do. .. 12.7 4.4 19 Land battles........ 30.0 11.0

The danger both of wounds and death in these contests was three times as great in the single ships as in fleets, and about five times as great in battles with the Americans as in fleet-battles with other nations. The dangers in fleet-battles were about half as great as those in land-battles, and these were but little more than half as great as those in fights with single ships.

COMPARATIVE DANGER OF CAMP AND BATTLE-FIELD.

These records of land-battles show that the dangers from that cause are not very great; probably they are less than the world imagines; certainly they are much less than those of the camp. Of the 176,007 admitted into the regimental hospitals during the Peninsular War, only 20,886 were from wounds, the rest from diseases; fourteen-fifteenths of the burden on the hospitals in that war, through forty-two months, were diseased patients, and only one-fifteenth were wounded. In the Crimean War, 11.2 per cent. in the hospitals suffered from injuries in battle, and 88.8 per cent. from other causes. 10 per cent. of the French patients in the same war were wounded, and 90 per cent. had fevers, etc. In the autumn of 1814, there were 815 patients in the great military hospital at Burlington, Vermont. Of these 50 were wounded, and the rest had the diseases of the camp.

In the Crimean War, 16,296 died from disease, and 4,774 from injuries received in battle. In the Peninsular War, 25,304 died of disease, and 9,450 from wounds.

During eighteen years, 1840 to 1857, 19,504 were discharged from the home, and 21,325 from the foreign stations of the British army. Of these, 541, or 2.7 per cent. of those at home, and 3,708, or 17.3 per cent. abroad, were on account of wounds and fractures, and the others on account of disease, debility, and exhaustion.

NATIONS DO NOT LEARN FROM EXPERIENCE TO PREPARE FOR ARMY-SICKNESS.

Nations, when they go to war, prepare to inflict injury and death on their opponents, and make up their minds to receive the same in return; but they seem neither to look nor to prepare for sickness and death in their camps. And when these come upon their armies, they seem either to shut their eyes to the facts, or submit to the loss as to a disturbance in Nature, a storm, a drought, or an earthquake, which they can neither prevent nor provide for, and for which they feel no responsibility, but only hope that it will not happen again. Nevertheless, this waste of life has followed every army which has been made to violate the laws of health, in privations, exposures, and hardships, and whose internal history is known. The experience of such disastrous campaigns ought to induce Governments to inquire into the causes of the suffering and loss, and to learn whether they are not engaged in a struggle against Nature, in which they must certainly fail, and endeavoring to make the human body bear burdens and labors which are beyond its strength. But Governments are slow to learn, especially sanitary lessons. The British army suffered and died in great numbers at Walcheren and South Beveland, in the middle of the last century. Pringle described the sad condition of those troops, and warned his nation against a similar exposure; yet, sixty years later, the Ministry sent another army to the same place, to sink under the malarious influences and diseases in the same way. The English troops at Jamaica were stationed in the low grounds, where, "for many generations," "the average annual mortality was 13 per cent." "A recommendation for their removal from the plains to the mountains was made so far back as 1791. Numerous reports were sent to the Government, advising that a higher situation should be selected"; but it was not until 1837, after nearly half a century of experience and warning, that the Ministry opened their eyes to this cost of life and money in excessive sickness and mortality, and then removed the garrison to Maroontown, where the death-rate fell to 2 per cent., or less than one-sixth of what it had been[50].

The American army, in the war with Great Britain fifty years ago, suffered from the want of proper provision for their necessities and comfort, from exposures and hardships, so that sometimes half its force was unavailable; yet, at the present moment, a monstrous army is collected and sent to the field, under the same regulations, and with the same idea of man's indefinite power of endurance, and the responsibility and superintendence of their health is left, in large measure, to an accidental and outside body of men, the Sanitary Commission, which, although an institution of great heart and energy, and supported by the sympathies and cooperation of the whole people, is yet doing a work that ought to be done by the Government, and carrying out a plan of operations that should be inseparably associated with the original creation of the army and the whole management of the war.

CRIMEAN WAR.

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.