Report on the medical arrangements in the South African war / by Surgeon-General Sir W. D. Wilson.
- Great Britain. Army Medical Services
- Date:
- 1904
Licence: Public Domain Mark
Credit: Report on the medical arrangements in the South African war / by Surgeon-General Sir W. D. Wilson. Source: Wellcome Collection.
57/490 page 41
![4] disseminated throughout the country by natives returning from the Rand, and probably also from Kimberley. The local conditions were then an endemic area provided with an impure water supply, and in a bad sanitary condition generally. To this was added the human factor, an army exhausted by excessive exertion on a reduced diet, marching through a district where the only available water supply was scanty, and probably in many instances polluted. Turning now to the history of the force which was exposed to these conditions, before it left the western line, enteric fever had been steadily increasing on the line between De Aar and Kimberley since the end of December, though the rate of incidence was not great in proportion to the strength of the troops. But in spite of the factors for evil which influenced the troops during the march, the general health at its beginning was good. Few cases of enteric fever had occurred, only six were admitted to the field hospitals during the first fortnight of the advance, and between March 2nd and 16th, 31 more. One has, of course, to consider along with enteric fever the so-called “simple continued fever,” of which, during February, 78 cases were admitted to the field hospitals with the moving force, and 114 into the Guards Field Hospital at Klip Drift. During the third and fourth weeks ef the march (ending March 2nd and 9th respectively for the purposes of the hospital returns), the admissions included under this head increased consider- ably, to fall again during the week ending March 16th. A large number of these cases of simple continued fever were undoubtedly due to fatigue, exposure, and other transient causes; this is shown by the numbers who returned to duty in a few days, which would have been materially increased had the transport available allowed of their being carried for a day or two. On the other hand, it is certain that some of these cases were the early stages of enteric fever. What the proportion was, it is not possible to say, but probably about one-third of the total would prove to be enteric fever. Calculation on this basis gives a total of about 220 cases of enteric fever in a force of nearly 34,000 men during a period of five weeks, or an admission rate over the period of about 14 per 1,000 per week. The force left the western line on February 11th. From that date, inclusive, to March 2nd is 20 days, so that the admissions of the second and - third weeks of the march (ending on February 23rd and March 2nd for the weekly retvrns) include the majority of the cases due to infection at Modder River. The admissions for the following week (March 9th) certainly exhaust the cases directly due to this infection, and probably include a large number contracted at Paardeberg, where the first exposure to infection dates from February 18th. On March 16th, there were in the various field hospitals of the force in and around Bloemfontein 327 cases, of whom 17 were enteric fever and 93 simple continued fever. This is exclusive of the 13th Brigade Field Hospital then at Driefontem. It must be remembered that, including the cases in this hospital (415), the total of 742 sick and wounded represents the total sickness in the force on the march from Poplar Grove, from which place the last convoy went back to the western line. That is, on its arrival in Bloemfontein, the proportion of the foree under Lord Roberts in touch with it, but inefficient on account of wounds or disease, was a little over 2 per cent. of the strength. . But immediately that the stimulus of the movement ceased, history repeated itself, and the sick rate began to increase. On the one hand, men who felt ill were no longer reluctant to report sick, and on the other, the effects of the march across the Free State became apparent. During the first week after the occupation of Bloemfontein, the admissions for the continued fevers (enteric and simple continued fevers) were nearly treble those of tie previous week, and the numbers still further increased in the following week (ending March 30th). These probably exhaust practically the whole of the cases contracted on the march to Bloemfontein. The beginning of the out- break among the Boer prisoners at Simonstown (already referred to) was synchronous with the increase in Bloemfontein. The total admissions from all causes increased steadily till, in the third week in April, the admissions to hospital exceeded 1,400. During the next two weeks the number of admissions: fell somewhat, but afterwards increased,](https://iiif.wellcomecollection.org/image/b32172874_0057.jp2/full/800%2C/0/default.jpg)
