The Sun.
London, England, 1856-02-07 00:00:00

" CAUSES OF MORTALITY.

" The returns of sickness and mortality furnished by the
medical officers relate to matters which are beyond the limits
assigned to this inquiry, and, therefore, have not been sub-
mitted on this occasion ; but the mortality in the Crimea has
been too remarkable not to excite a strong desire to ascer-
tain, if possible, its causes. The medical evidence appears to
be conclusive against attributing it to anything peculiarly
unfavourable in the climate, and all the officers, of whatever
rank or profession, whom we examined, referred to overwork,
improper diet, exposure to cold and moisture, with deficient
shelter, inadequate clothing, and defective boots, as the
causes of disease. Some of the witnesses appeared to attri-
bute greater influence to one of these causes, some to another,
but there can be no doubt that the mortality was really the
effect, not of any cause apart from the others, but of a com-
bination of the whole. It was the greatest among the in-
fantry corps employed in front, upon whom the duty fell
most severely, but those corps were also more exposed to the
other causes of disease. The harbour of Balaklava was the
source of all supplies, and the corps necessarily suffered more
than the rest of the army from the deficiency of transport.
When the men were compelled, in consequence, to carry up
their own stores of every sort, they suffered in proportion to
the distance to be traversed in the mud, and the length of
time they were exposed to the weather.
The corps stationed in front also suffered more from the
deficiency of everything that was necessary to the proper
treatment of the sick ; they could not even get their share of
such supplies as, could be procured at Balaklava. Men who
were struck down by disease in the camp in front had thus
less chance of recovering than those of other corps, and the
proportion of deaths to admissions into hospital is accordingly
much greater than in the rest of the army. But that is not
all; when patients were to be sent to Scutari the difficulty of
removing them from the front to the harbour was sometimes
found to be insuperable, in consequence of the want of trans-
port, while the corps stationed near Balaklava removed them
with comparative facility. Even when the means of convey-
ance were provided, it was a formidable demand upon a sick
man's remaining strength to require him to sit, exposed to the
weather, upon a cavalry horse or a pack mule, floundering
through deep mud, for the two pr three hours which the jour-
ney from the front to Balaklava occupied during a great part
of the winter. His chance of recovery was thus further dimi-
nished by the delay, the exposure, and the fatigue attending
his removal.

" The mortality in the whole army was further increased
by the disease which broke out at Scutari, and carried off
many men who had entered the hospital with a prospect of
speedy recovery, or who had actually recovered from the dis-
eases for which they were admitted. Had the sanitary condi-
tion of those establishments been from the first what it after-
wards became, there can be little doubt that the mortality
would have been perceptibly reduced.

" MEDICAL SUPPLIES.

" The supplies and arrangements connected with the me-
dical department of the army in the Crimea have been in-
vestigated by a medical commission, whose report supersedes
the necessity for any detailed consideration by us of those
subjects; but, as much of the evidence we have received re-
lates to a period subsequent to the date of that report, we
think it right to state shortly the results of the information
we have obtained.

" The army landed in the Crimea without hospital mar-
quees, conveyance for the sick, or any other supplies for the
hospitals than were contained in the pair of panniers belong-
ing to each corps, and the supplies of almost every descrip-
tion required for the proper accommodation and treatment of
the sick in camp seem to have been ♦ery deficient till the
middle of February. There was also a scarcity of cots, or of
any substitute, such as boards and trestles ; but this was not
much complained of, because they could not have been used
in the tents in which most of the sick were placed. There
was a great deficiency of mattresses ; and straw, or other
materials to fill paillasses could not be supplied ; and even
as late as the month of April many of the sick in front had no
other bedding than blankets or buffalo robes, the latter of
which were not issued till the end of January. They suffered
still more, perhaps, from the want of adequate shelter and
sufficient space to admit of their being properly attended to ;
as, owing to the want of hospital marquees in the camp, the
greater part of the sick lay in circular tents,* which are alto-
gether unfitted for the purposes of an hospital, and it was not
until the huts sent out from England were erected in Febru-
ary and March that the accommodation was such as to admit
of proper medical treatment.

" Nearly all the medical officers of the infantry corps in
front complained of the want of transport to bring up from
Balaklava even the most indispensable supplies to the hospi-
tal. Major-General Codringtou, commanding the first bri-
gade of the Light Division, says :-4 The hospitals suffered
terribly from this want of transport. Their state was fright-
ful, from the increasing number of sick, the diminishing
means of transport, and the consequent impossibility of doing
anything for the sick.'
" During the month of February the supplies of medi-
cines and medical comforts began to improve, and by the
middle seem to have been generally ample.
T
nk ts and tbo supply of buffalo robes in the
enhdeoisfsJuae of
3a
January fuorarihyllahl theyad previously provided a tolerable substitute
for bedding, and when the hospital huts were erected, these,
together with such marquees as the corps had previously pos-
sessed, afforded sufficient and comfortable accommodation.
In the month of April, When fresh bread was issued, the me-
dical officers generally declared that they were,perfectly satis-
fied with the supplies and the accommodation provided for
their patients.
" Even after the supplies of medicines had become gene-
rally abundant, it occasionally.happened that some •f those
which were most employed by the medical officers could not
be supplied from the general store. Thus there had been a
deficiency of opium and of some other medicines much em-
ployed during the prevalence of diseases of the bowels, and
after the store had been amply replenished with those reme-
dies the decrease of that class of ailments and the increase of
fevers caused a demand for quinine which the stores were not
always able to satisfy.
" The proportion of deaths to admissions in some of the
diseases bears painful evidence, particularly in the month of
December, to the absence of those remedies on which reliance
could best be placed for relief. In cholera, for instance, the
usual loss has, in our army, been about one in three at home,
or on foreign stations where this epidemic has prevailed ; but
in the Crimea, during the period under observation, it was
two in every three attacked.
" As instances of the difficulty of procuring medicines, we
have given the requisitions made by several of the medical
officers, with the quantities received ; but it must not be
supposed, because no such deficiency appears in the requisi-
tions of others, that they received all they wanted. Most of
the officers, finding it useless to scud for medicines and medi-
cal comforts not in store, limited their requisitions to such as
they knew could be given, and did the best they could with
them.

'—;;-The circumstances in which the medical officers were
p
placed,
descriptionowing
ethe d i
et,accommodation, want of t those
or comfort e supplies, as well as of
every
essen-
tial to the recovery of the sick, were the most painful that
can be conceived. We prefer leavlng it to be described in
their own words, and shall confine ourselves to the expression
l ac
of our conviction that if they were unsuccessful in their treat-
ment to an extent which has seldom occurred in the annals
of medical practice, it has not been for want of constant at-
tention and unceasing and energetic efforts on behalf of their
patients. The appeals of s)me of them to those authorities
whom they, perhaps erroneously, conceived had the power of
assisting them were most forcible and pathetic ; and if all did