Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty.
- Great Britain. Royal Commission Appointed to Inquire into the Sanitary Condition of the Army.
- Date:
- 1858
Licence: Public Domain Mark
Credit: Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
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![Servia, Bulgaria, &c.,for the information of his Lordship the General Commanding-in-Chief, and to solicit special attention to the second paragraph. Most of the communications I receive from medical oflicers serving in the East speak of the great severity of the climate at certain times of the year; it will, therefore, be essential to the safety of the soldier that an ample supply of bedding, flannel vi^aistcoats, and flannel drawers be in Turkey for issue to the troops before the next cold season sets in. I have, &c. (Signed) A. Smith, The Military Secretary, Director General. &c. &c. (Extract.) Prophylaxis, &c. 1st. I should recommend that every man in the army should in the early part of the autumn be pro- vided with flannel jackets and drawers, to be worn till the nponth of May following. Our soldiers are half clad. This climate for nine months in the year, with its abrupt and trying transi- tions from great heat to the most severe cold, requires the adoption of the above suggestion as a measure of the flrst importance for the preservation of the health of our troops. 2nd. During seasons, and in localities where endemic diseases prevail, I think that soldiers exposed to the evening and morning exhalations from malaria- producted ground should have a small ration of diluted spirit, medicated with quinine, given to them, an hour before sunset and before daybreak. A couple of grains of quinine given at such times would exer- cise a very salutary eflect as an antidote. This plan dates from the days of Lind; it obtains in the navy, and is worthy of serious consideration, for I believe that cinchona has as much an antidotal as a remedial power. 3rd. In notoriously unhealthy places the sentries should be changed every hour. This may involve loss of rest, but it will break the force of the pesti- lential emanations if we can lessen the period of continuous exposure to them. 4th. The introduction of a good warm hood, as worn in the Turkish army, on night duties, or where the men are exposed to severe weather, Avould be an admirable addition to the soldier's dress, and would jjrotect him from cold as well as disease. Let us imitate the inhabitants of all classes in these countries, who universally wear this in circumstances where protection is sought from cold and damp. The hood worn by the Turkish soldier will serve a double purpose. Pulled over the men's forage caps, it will save them from the chilling effect of the cold at night, piercing in these climates, and as it has two woollen straps, each a yard long, these brouglit over and round the neck and mouth, and tied, would form an excellent respirator and sifter of malarious exhalations, 5th. Immediately on the occupation of a town or neighbourhood of evil (sanitary) reputation, large fatigue parties should be at once employed in removing or lessening all patent or suspected causes of disease. Foul ditches should be cleaned, pent-up pools of stagnant water should be given vent to; exuberant vegetation, when not a screen against malaria, should be cut down; theiilthy accumulations of mud, ordure, and numberless impurities with which Mussulman towns are polluted, should be removed. 6th. Much of the river water in Bulgaria is bad, surcharged with lime, and at some parts of the country, for example, on the large plains stretching from Widdin to the east, is far from plenty. For our hospitals filters would be desiderata, or some substitute for these. Felt, for instance, is used for this purpose in, I think, the Austrian army. When water is unwholesome, alum as a means of purifying turbid water I have just heard of. In the Turkish army there is attached to each regiment a certain number of men, about twenty-five to a battalion, whose duty it is to provide wholesome water for the soldiers. Each of these men has a horse laden with two immense bags, with a hose at the bottom Oi each. The duty of these men is to keep the regiment supplied with good water; they ])ring it to the hospitals and barracks. On a march they precede the advancing corps or army, and then meet it laden with water drawn from the purest sources, such as fountains, &c. When an army is encamped, these men still labour at their vocation, bringing good water, filling the recipients procured for it, and always keeping up an abundant and whole- some supply. Some arrangement of this sort (we cannot do better than imitate the Turk) is wanted with us. 7th. Short marches, particularly when troops first take the field. 8th. The formation of open fireplaces, or the intro- duction of stoves into the Avards of hospitals, or build- ings used as such. The mode of house heating is most objectionable. The ' mangal' is a large dish of live charcoal, and on the introduction of this into the room or ward they are dependent for warmth. Two or three of these things would be insufficient to keep up a proper temperature if ventilation were also cared for; but this is disregarded, and as the windows are kept closed, large mattings are hung before the doors, and not a breath of air finds admittance, the atmo- sphere is naturally polluted and unwholesome, the Avards are all stuffy and close, and I think at Widdin that the epidemic typhus and dysentery there pre- vailing were invited to establish themselves by Jie atmosphere provided and maintained for them by this miserable contrivance. Burning wood in an open fireplace would assist and promote ventilation. This, and a good stove, would warm the largest ward or barrack room, and we should escape from the suffo- cating ' mangal' and its consequences. 9th. Avoiding as quarters towns deep sunk in valleys, where ventilation is obviously Avanting. Towns so placed are ahvays unhealthy. 10th. In these countries there are scarcely any tables. The Turk eats off a tray placed on a low stool, and he Avrites on his knee. Each regiment should carry with it a portable operating table. 14th March 1854.—Belgrade, the capital of Servia, is situated on an advanced elevated angle of land, jutting out Avhere the Save joins the Danube, one side of the promontory being washed by the Save, the Danube skirting its other aspect. The apex of the headland is croAvned by the fortress of Belgrade, Avhich beetles over the valleys of both rivers. Retiring inland from this point, the crests of the ridge is found covered by the Servian parts of the town, the slope and low ground, at both sides of this hill, are the Turkish and JcAvish quarters. In all direc- tions except inland Ave see fever-producing country, the desolate-looking banat of Temeswar stretching far on one side, and the low undrained tract lying be- tAveen the Save and Semlin are both alike unhealthy. The Save often escapes from its banks, and then Ave have part of the loAver town under Avater. Then follow the fevers of the summer months, which prevail especially in this quarter of the city. The soldiers in the elevated citadel would be comparatively safe, but the sentries furnished to this district are exposed to the influence of its malai'ia, and thus contract periodic fevers. The water of Belgrade is bad ; that used in the military hospital is filtered through dr^p-stones. Belgrade is very badly supplied Avith food. The Servian peasant is rich, and Avill scarcely take the trouble to breed stock or seek a market for it ; he tills a patch of land for maize, rears hogs for expor- tation, and the communities of large towns are left to look to exterior sources for supplies. 15th March.—Belgrade to Grotzko, four and a half hours. Leaving Belgrade, and going east by B](https://iiif.wellcomecollection.org/image/b21365210_0769.jp2/full/800%2C/0/default.jpg)
