# National Geographic Magazine/Volume 16/Number 2/Observations on the Russo-Japanese War in Japan and Manchuria

OBSERVATIONS ON THE RUSSO-JAPANESE WAR, IN JAPAN AND MANCHURIA
By Dr Louis Livingstone Seaman
The Japanese soldier has been taught how to treat his intestines, and consequently his intestines are now treating him with equal consideration. His plain, rational diet is digested, metabolized and assimilated. It is not an irritating, indigestible, fermenting mess, acting as a local irritant and producing gastritis, duodenitis, enteritis, colitis, hepatitis, and the long list of inflammatory intestinal processes with which we were all so familiar in the hospital wards at Camp Alger, Chattanooga, Tampa, Cuba, Porto Rico, Montauk Point, &c, in 1898.
The great hospitals are there, interne, contagious, and infectious departments, their conspicuously empty beds voicing more eloquently than words the most important lesson of the war. A few cases of diseases of the respiratory system are found—colds, bronchitis, and an occasional pneumonia—contracted through exposure in fording rivers, exhaustive marches, and bivouacking on wet ground, a few more of typhoid (I saw only three in Manchuria), occasionally one of dysentery, and a number of cases of beri beri, that former scourge of oriental armies.
But of all the many thousands gathered in these institutions there were but ​a few medical cases, and of these scarcely a baker's dozen came under the heading of " Diseases of the digestive system." Therein lies one of the greatest secrets of the Japanese success. Napoleon never made a more truthful statement than when he said : "An army fights on its belly." The Japanese have that belly, and they take good care to keep it in fighting order, not by insulting it three times a day by cramming it with material totally unsuited to the soldier's necessities, thereby exciting irritations and disease, but by supplying it with a plain, palatable, easily prepared and easily digested ration that can be thoroughly metabolized and converted into the health and energy that make its owner the ideal fighting machine of the world today.
The organization of the medical de- partment of the Japanese army and navy is modeled after that of the Germans, with many added improvements. Too much praise cannot be bestowed upon the medical department of the army and navy for their splendid preparatory work in this war. The Japanese are the first to recognize the true value of an army medical corps. The medical officer is omnipresent. You will find him in countless places where in an American or British army he has no place. He is as much at the front as in the rear. He is with the first screen of scouts with his microscope and chemicals, testing and labeling wells so the army to follow shall drink no contaminated water. When the scouts reach a town he immediately institutes a thorough examination of its sanitary condition, and if contagion or infection is found he quarantines and places a guard around the dangerous district. Notices are posted, so the ap- proaching column is warned, and no soldiers are billeted where danger exists. Microscopic blood tests are made in all fever cases and bacteriological experts, fully equipped, form part of the staff of every divisional headquarters.
The medical officer is also found in camp, lecturing the men on sanitation and the hundred and one details of personal hygiene — how to cook, to eat, and when not to drink, to bathe, and even to the direction of the paring and cleansing of the finger nails to prevent danger from bacteria. Up to August 1, 9,682 cases had been received at the reserve hospital at Hiroshima, of whom 6,636 were wounded. Of the entire number up to that time only 34 had died.
It is the rule of the Japanese surgeons at the front to do little or no operating except in cases of extreme emergency or where hemorrhage threatens immediate death. All cases are treated by the ap- plication of the first aid dressing and then sent to the rear as quickly as pos- sible, thence by hospital boat or trans- port to the base hospitals in Japan. If the testimony of those conversant with the facts can be accepted, supple- mented from my own limited observa- tions, the loss from preventable diseases in the first six months of this terrible conflict will be but a fraction of 1 per cent. This, too, in a country notori- ously insanitary. Compare this with the fearful losses of the British from preventable diseases in South Africa, or, worse, with our own losses in the Spanish- American war — where, in a campaign the actual hostilities of which lasted six weeks, the mortality from bullets and wounds was 268, while that from disease reached the appalling num- ber of 3,862, or about 14 to 1, or 70 per cent — 1 per cent against 70 per cent. Naturally one asks, Were these results anticipated ? As an answer, the statement of a distinguished Japanese officer, when discussing with me the subject of Russia's overwhelming numbers, is pertinent. "Yes," he said, "we are prepared for that. Russia may be able to place 2,000,000 men in the field. We can furnish 500,000. You know in every war four men die of disease for every one who falls from ​bullets. That will be the position of Russia in this war. We propose to eliminate disease as a factor. Every man who dies in our army must fall on the field of battle. In this way we shall neutralize the superiority of Russian numbers and stand on a comparatively equal footing."
Japan is the first country in the world to recognize that the greatest enemy in war is not the army of the invader, but of a foe more treacherous and dangerous — preventable disease, found lurking in every camp.
If wars are inevitable and the slaughter of men must go on — and I believe wars are inevitable and that most of them are ultimately beneficial — then, for the love of God, let our men be killed legitimately, on the field, fighting for the stake at issue — not drop them by the wayside by preventable disease, as we did in the Spanish-American war — 1,400 for every 100 that died in action. It is for the 1,400 poor devils who are sacrificed — never for the 100 who fall gallantly fighting — that I offer my prayer.
The state deprives the soldier of his liberty, prescribes his exercises, equipment, dress, diet, the locality in which he shall reside, and in the hour of danger expects him, if necessary, to lay down his life in its defense and honor. It should therefore give him the best sanitation and the best medical supervision that the science of the age — be it Japanese or Patagonian — can devise.