Evening Republican, Volume 18, Number 155, Rensselaer, Jasper County, 2 July 1914 — AMERICAN ARMY CAMP SANITATION IN OLD MEXICO [ARTICLE]

AMERICAN ARMY CAMP SANITATION IN OLD MEXICO

Surgeon Genera! Gorgas Tells Proper Methods to Pursue. Sanitary Precautions Which Will Be Taken to Safeguard Health of Troops in Event of Invasion of Tropical Country.

By WILLIAM C. GORGAS,

Surgeon General, U. S. A. Washington.-—ln the event of an invasion of » sub-tropical country by our army the sanitary precautions to be observed by our troops would be of supreme importance. The neglect of them might indeed be fatal to the success of the campaign, just as the British in 1763 were compelled by disease to withdraw from Cuba after they had taken Havana. Our precautions must, however, begin at home in our assembly and concentration camps. There is no question but that this will be done, and all sanitary precautions that military exigency can permit will be observed in Mexico.

In the war with Spain in 1898 we were handicapped by lack of training and experience in camp sanitation. We had practically no experience *ln the tropics. While we had gone into Mexico in 1846, there was little of the knowledge then existing of tropical diseases that has been since accumulated in India, Africa, eastern Asia and tropical America. Nor did the memory of what we may have learned in Mexico come down to us 42 years later. The great development of preventive medicine was not then in a stage convenient for practical application. The people were not educated up to its ideas. This is now all changed and the conditions under which we may go into tropical or sub-tropical lands give us considerable assurance, where before we went timidly and fearful of consequences. —>

Two Precautionary Stages. In any contemplated occupation of a country lying partly in the tropics by an army coming from the temperate zone there would be two stages to consider with reference to the precautions necessary to the preservation of the health of such a command — first, the measures required to avoid the “camp diseases” in the homeland while the’troops were mobilizing and training and, second, the measures required to avoid the diseases peculiar to the country to be occupied. It may be added that under theiatter circumstances there might be camp diseases in the occupied country, the same as. in the home country. The first sanitary precaution is to secure healthy soldiers physically sound men. Then it is necessary to safeguard their health while in training by giving them pure food, water and healthy camp surroundings and by preventing the entrance to such camps of infectious diseases. Our camps iuthl? country would naturally be selected with a view to salubrity. The supply of water must be given the same care and safeguarding that 'he supply of one of our cities receives. The selection of sites for large camps of concentration is influenced to a greater extent by this one matter than by any other consideration but military necessity. In successfully taking all precautions relating to water we assist in avoiding typhoid fever and the dysenteries — the camp diseases of all former wars. These diseases are also communicated by foods of some kinds, particularly the uncooked ones, and milk. Consequently the sanitary officers must inspect and examine the water and food, including milk, with the special purpose of keeping out the diseases thus transmitted. Of course,, as these diseases are spread by contact as well as mechanically by files and possibly other insects, such methods of transmission must be watched for and prevented. principally by the early exclusion of all cases of these diseases, ’’he means available to protect the

camp water supply in semi-permanent camps in the home country are all those employed by intelligent civil communities. Drinking Water Problem. In large, semi-permanent camps, when troops are assembled for the purpose of instruction and equipment awaiting transportation to the scene of campaign, it is usual to bring the water into camp and distribute it to the kitchens and shower baths by a fairly elaborate system of pipes. If the source of supply is good we have no more danger under the circumstances than we have in a small city.

When we have to deal with the question of potable water in the enemy’s country, and especially in the field, we deal with a more difficult problem, but by no meals a hopeless one. Efforts are made to ascertain

the quality of the water by examination and by its reputation when that is practicable. When deemed necessary—and this is the case with# all surface waters in the tropics, unless we except some mountain streams — we try to render the water safe for drinking purposes by such measures as may be possible in the field. However, it will often occur that under military stress, lack of time and transportation troops for short periods must use the water that the natives depend upon. Under these circumstances we may look for the appearance of such diseases as are water borne and are prevalent in the communities using the water.

The methods to render the water potable are naturally those used in temporary emergencies as a rule — boiling, filtering and the; use of chemicals. Portable appliances are used in the army to render the water safe. When this is not practicable we may always fall back upon boiling, for this may be actually done by the individual soldier with his metal cup as the receptacle. It has been found, however, that it Is an Impracticable and almost impossible procedure, as to accomplish such a measure requires fuel, the fire, time to boil and time to cool the water to enable it to be drunk. Either the soldier has, in the heat of the march or battle, to drink water as he finds it or some simple method has to be devised that may meet this necessity in a more practicable manner.

The field filter weighs 60 pounds, and this limits its use to such columns as are provided with transport tation to carry it about. The practical use of calcium chloride as a disinfecting agency is excessive in cities. Its use in portable plants in suitable form for armies has not been satisfactorily worked out but promises a possible solution for this vexing question. Disposal of Wastes. Only less important than a supply of potable water in camp is an efficient method for the disposal of. ,hu-„ man wastes. Excreta in camp become a most dangerous focus for the dissemination of such diseases as are spread through this means by direct contamination or pollution of water and milk and by files. In the last large camps maintained by the army in Texas in 1911 and 1913, a most efficient system was used. On still larger scale, but for a shorter time, the same system was fn use at the Gettysburg reunion in 1913. Briefly, this consists for each company organization of a, trench sixteen to twenty feet long, two to two and one-half feet wide and six feet deep. Over this is placed a box cover, which forms a seat with tight/ covers. The whole box ffts to the ground so closely and is so tightly made that flies are excluded. Each morning a gallon of oil and 15 pounds of straw are burned in this trench. This has the effect of destroying fly larvae, incinerating the I surface of the contents of the trench | and its solid walls and deodorizing. For "h year in the Texas canyis this system has given complete satisfaction. It will be observed that again the distinction must be made between camps semi-permanent In character and the camp of troops actually in the field. For the latter, of course, no elaborate system Is appropriate. Shallow trenches are used and covered after 2| hours. The facilities provided for the civil population are used when troops are in possession of towns and cities. The use of deep trenches In camp is somewhat limited by the character of the ground. High ground water and rocky outcrops forbid their use. ■Ate can then use very satisfactory Incinerate®! In setni-permanent camps. These are more expensive, aS fuel Is required. When a large camp is In

the environs of a city with a sewerage system and is to be occupied for a considerable time connection may be made with the established city system. This was actually done during the past few months at Texas City. This system was devised by the Vaughn-Reed-Shakespeare board, which investigated the typhoid epidemics in the camps during the war with Spain. This is known as the Reed trough system, and is merely a galvanized iron trough and urinal that contains a mixture of lime and water. As the excrement and urine are deposited into this they are not disturbed by flies. The contents of the trough are removed at intervals by an odorless excavator and deposited at a distance on fields as a fertilizer. This systemlslimltedtd wliathef condltions that do not reach the freezing poipt. Moving Armies Police Themselves. It has been an axiom in past wan that moving armies were healthy. This is merely an expression of the fact that moving troops- get away from their own camp pollution. This is still true unless the troops in semipermanent camps are protected from themselves by a sanitary system for the disposal of human wastes. To a lesser extent the other camp wastes are a menace to the health of troops, if neglected.

There exists, then, a yeast to deaven the whole that was absent in 1898. Since that eventful year the officers of the medical department of the army have been studying and practising military hygiene and sanitation with brilliant results, as demonstrated in the two large camps in Texas. Here 10,000 men lived for a year at a time with a sick rate lower than that at the average post. Better yet, the officers of the line, impressed with the value of the lessons In camp sanitation, have been enthusiastic supportters of these advances and. are hardly second to medical officers in their knowledge and experience In such matters. The army, then, Is in an entirely different position than at the outbreak of the Spanish war. The 20,000 cases of typhoid that then puzzled and distressed the people of this country will not appear as specters In our camps as a sign of sanitary incompetence.

Anti-typhoid Inoculation, which has been in vogue in the army since 1909, and which so efficiently protected it In 1913 that there was but one case among the inoculated in the army of 90,000, is to be trusted to keep our camps free of this disease so fatal to armies in the past. The dysenteries will be held in abeyance by many of the precautions that prevent typhoid, particularly the safeguarding of water and the early exclusion of such cases from the camps. Yellow fever is robbed of much of its terror by the fact learned In 1898 by Reed and his devoted band, which taught us the means of transmission and, consequently, the manner of avoiding ft. The soldier carries in the field a mosquito bar weighing 13 ounces that enables him to sleep tn comfort and safety. The sentry on duty is protected with, a head net that serves the same purpose. These are the diseases that, if avoided, will make any campaign in the tropics unique in history.

Typhus an Ancient Enemy. One other disease there is that may be a possible cause of alarm —that until recently might have been difficult to prevent. It is a disease that has played a tremendous part in all great European wars In the past and has even determined the fate of campaigns since the Peloponnessian war—, typhus fever. Fortunately, and thanks to officers of the public service, as well as to a brilliant Frenchman, we have learned that It is spfead by the bite of the louse and. In consequence, we . are enabled to limit its ravages. I have not mentioned smallpox, as it is not peculiar to armies, and its preventive measure of vaccination is so well known as to require no further mention.

Thus, forewarned, we are forearmed and enter any campaign confident' of our ability and in the sanitary training of the line feel that we can exist in the campaign in such a state of "hygienic competence” that the disabilities of the war will be limited, for the first time in the history of the hew world, to wounds,“and‘thsit disease will not kill more than bullets. The American people will have what they should have for the generous support given every year—the most efficient army of its size in the world. L-Engineering Record.