Evening star., 1898-11-21

been reported in full. 1t appears to me-
! however, from a general review of the san
| 1tary reports already filed that The preva-
| lenIe of the disease propOrtiOned to the
| insanitary camp conditions which l have re-
| ferred to. My circular No. /. already cited
| was intended to bring the danger from this
| fever to the notice of medical officers, with
| the view of obviating it. The probability
| of its communication to soldiers i'll camp
| through the agency of flies pointed out
| as reason for insisting a sanitary police
| of the StricteSt character.
| Contaminated Water supply.
1T is well known to the medical profes-
! sion tnat this fever is propagated by Il con-
/ taulnated water supply, and it is now rec
| ognized that the great prevalence of this
/ disease in aggravated form in the camps
| of the civil war was due to the use of sur
| face and shallow well waters infected by
I typhoid eXcreta.~ To prevent transmission
! by the water supply | recommended the use
| of boiled and filtered water when a pure
| spring supply could not be obtained. and to
| enable an efficient filtration of suspected
| waters to be made, field filters of approved
| construction were issued on my recommen-
| dation 10y the quartermaster department.
The method of hospital organization in
| these camps was practically the same; and
| there was much similarity in the conditions
| affecting them and CurreSpCndiuEly in their
| history. Regiments reported in but few
| instances witt the material and supplies
| for their medical care; but they brought
sick men with them. and these required i'm
mediate care. Provision had to be made for
division hospitals IN view of future field
service, and for regmental hospitals in
view OF the immediate necessity. The SICK
had to be cared for, and to this end medi-
cines and other things had to be procured.
hehef societies offered assistance, and this
was largely offered assistance, and this
medical officers, not alone for delicacies
iuXuries not otherwise provided for. but
for supply table articles. which could
have been had from the medical purveyors
ton on the surgeon general. 1t was easier
to accept what freely offered than
to learn how to obtain the articles from
the proper source. To explain their prompt
acceptance of this assistance these officers
referred to the red tape of the War De-
partment methods and the insinuation that
the said methods were beyond the compre-
hension of the ordinary intellect was
cepted by the sensational press
PLANTATION in full.
The Hospitals.
Chief surgeons OF corps and divisions
began the organization and equipment of
their field division hospitals and ambulance
companies, but they were met at the out
set by the apparent impossibility of secur-
ing men for service as cooks, nurses, litter
bearers. ambulance drivers, Ieamslers, etc.
As a rule the hospitals We're kept in cam
paiSnlng condition; that is the tents We're
neither framed nor foored, until the in
creased prevalence of typhoid fever at
dIjtutlUn 10 tNelf crowded cOnul-
tion, when the object of their existence be-
came suddenly changed from school for
field service to a hospital for the treatment
Of d local outbreak Of disease. Special diet
kitchens, under LIE mauag1 ment of capa-
Bile individuals. were opened al most o1
the hospitals. Money FOR TINS purpose was
sent to them by me from funds contributed
and placed at my disposal. Money also
sent directly by individuals and representa-
tNeS OF aid societies. and the Ited Cross
committees supplied quantities of ice and
milk, chicken, eSSs. lemons, etc. Pajamas,
night shirts and other articles of hospital
clothing We're also provided by the Red
Cross and other aid societies. Subsequent
ly the order authorizing the Communication
of the sick soldiers ration at 90 cents rem
dered these hospitals wholly Independent of
outside assistance.
Hospital Men in Demand.
The want of hospital corps men wgs
the main cause of the failure of Chief sur
geons to establish their division hospitals
promptly. Instead of organizing for field
service, their time was occupied and their
energies spent in endeavOring to procure
the necessary men by enlistment or transfer
After a time, when sickness invaded the
camps and the GiSVlsiOn hospitals became
filled, operations for field service had 70
give place to the immediate necessity OF
caring for the sick. The division hospitals
became expanded, as at Sigoney and Tampa,
into base hospitals, with increased needs
and increased responsibilities.
1T is needless to refer at this time to the
complaints of starvation which appeared
almost daily in the new spapers during the
occupation of Camp Wikof, for it is now
generally understood that the weakness
Erustration, anaemia and emaciatiOn of SO
many Of the troops were the results of ma
larial. typhoid and yellow fever, from
which the army suffered as a consequence
OF its exposure to the climatic influences
and local infections of Santiago and its
reighborhood pending ard subsequent to
the surrender Of the city.
My report presents tabul2tionS complied
from monthly reports of sick and wounded
received from May TO September inclusive
and representing q strength present of 161,-
1GS men. These give full particulars of
f-TlJ deaths. of which number Gi0 were. oc.
casioned by typhoid fever, % by 1naiarial
fCyers and 3!B by diarrhoea and dySentery
The death rates for May and June, .46 and
40. were not in excess of those of the army
in time ~ peace. In July the rate became
somewhat higher than that of most well.
cared for cities, > Is for the month, or the
tqulyaisHt OF an annual rate of 1850 per
thousand living. In August ii became eX-
cessive, I.0S for the month, equal to an
annual rate OF 4S~ per thousand. In Sep
tonber the influence of the energetic meas
ures taken in July and August 10 improve
the health Of the army becomes manifest
in the falling Of the death rate to 10, or
the equivalent of an annual rate of 29.40
The same progression to an acme in Au.
gust with a sudden fall in September is
seen in the various ratios given under the
specific titles, typhoid fevers, malarial fe-
yer and diarrhoeal diseases. This is ex-
cecdiuGly gratifying and must be credited
stated. to the sanitary measures adopt
ed, for our experience in the civil dem
Cnstrates that in the absence of these
measures the high ratio of August would
have been continued for many months to
come
The Mortality Tables.
L submit also tables of absolute numbers
and of ratios by which the incidence of
sickness and mortality of the regular and
volunteer troops may be contrasted. From
these il will be seen that the exposures of
the regular troops during the Santiago
campaign gave them from June to Septem.
Der higher death rate than the volunteers
and that Jhe rate of the latter during Au-
gust, Tho month of maximum mortality
was 3.62 compared with 5S3 among the
regular troops.
My guiding principle throughout the war
has been that relief. when needed, should
be promptly accepted without reference to
the source from which II came. The relief
afforded by the National Red Cross at Sibo-
ney was promptly accepted by the surgeons
on the spot, but it is evident that it was
entirely inadequate to meet the emergency.
This association has had full authority to
send agents and supplies to all of our
camps since June Q. 1s9S. and it has con-