SECTION III.

CHOLERA HYGIENE AS APPLIED TO MILITARY

LIFE.

BY

ELY MCCLELLAN, M.D.,

MAJOR AND SURGEON U. S. ARMY.

CHAPTER XLII

CHOLERA HYGIENE AS APPLIED TO MILITARY LIFE.

THE hygiene of permanent military stations differs in no essential respect from that which applies to life in isolated dwellings and tenement houses.

Enlisted men are furnished with clothing, food and shelter by the general government. That these three requisites of life are properly provided, and that no one is deprived of his portion of them, is the duty and constant care of commanding officers. Enlisted men when sick and unable to perform duty are entitled to the professional care of a medical officer, who has under his charge a hospital most abundantly supplied with all that is necessary for the welfare of the men of the command.

It is the duty of the commanding officer of a post, and of the officers immediately in command of troops, to see that each enlisted man is protected in the receipt of all bounty from the government, and that he renders the full service in return. It is the duty of the medical officer to guard the public health of the command; to preserve the hygiene of the post at the highest available point, and to cause, so far as may be in his power, the destruction of what Sternberg has so aptly termed "our in

visible foes."

A permanent military post should afford an example of cleanliness in all things. Nothing should be permitted to remain in or around barracks or other buildings which may be prejudicial to health. Sewer connections, where they enter buildings, should be trapped and ventilated. Conveniences which require sewer connections should be reduced to a minimum. Dormitories should be freely ventilated, well lighted, and during the cold months properly warmed. Water-closets and urinals should under no circumstances be permitted under barrack roofs. Drains and sewers should be sufficiently often flushed to secure a removal of all débris deposited in them. A frequent and lavish use of disinfectants should be made. The quarters occupied by officers should be subjected to the same careful supervision as is bestowed upon the habitations of enlisted men.

The water supply of a garrison should be constantly a subject of observation. Water should be had from the very best obtainable source. The condition of supply pipes should be an object of constant care. When necessity compels the use of water from cisterns or wells, they should be kept in the most perfect order, and the greatest care should be had to avoid the introduction of any surface washings. When there is the least suspicion as to the purity of the water supply, it should always be boiled and filtered before use, and all members of a command should be enjoined to use only water so prepared.

Whenever it is practicable, water-closets should be provided for the use of all at a military post: they should be connected with the system of sewers which should empty in such position as will in no way interfere with the public health.

When it is impracticable to employ water-closets, privy vaults should be constructed in such positions as to secure isolation. These vaults should be so cemented as to prevent leakage, be frequently subjected to the action of disinfectants, and at short periods emptied of their contents. The disposition of the débris from such vaults should be a matter of careful solicitude. The lines of natural drainage around a post should be always a matter of care. They should be kept constantly free and unobstructed throughout their length.

The ration of the enlisted man in the U. S. Army is most liberal—it is the endeavor of officers charged with such supplies to furnish articles only of superior quality. The greatest care should be observed in the preparation of food in all company kitchens.

The clothing of a soldier is amply sufficient for all his requirements. In no other army, by no other nation, are enlisted men more perfectly cared for, and the American soldier is furnished with luxuries unknown to soldiers in other armies and to the majority of the working classes in any community.

The chief causes of sickness and mortality among troops are to be found more in the individual habits of soldiers than in their surroundings.

Whenever an epidemic of cholera or yellow fever occurs in the vicinity of a military post, it is well to cause the removal of troops to such position as will free them from immediate contact with the disease. The rules advanced by Niemeyer, governing such circumstances, are always good: "Start soon enough." ""Go as far as possible." "Do not return until the last trace of the disease has disappeared." Circumstances, however, will, especially in cholera epidemics, conspire to prevent the abandonment of a military post. At such a time a strict system of non-intercourse with infected or even suspected localities must be maintained. All enlisted men should be rigidly confined to the limits of the military reservation. A camp of observation should be established, in which all recruits or soldiers received from without should be placed. A watch should be kept upon privies, and any man obliged to make use of them more than once in twenty-four hours should be taken under observation and all subsequent dejections be made in such vessels as will allow his condition to be ascertained by inspection. No enlisted man should be permitted to eat, drink, or sleep outside his proper quarters.

While it is advisable for all persons to be careful in their diet, and rigidly to avoid all articles of food that are known to be indigestible, it is also necessary not to occasion too sudden and radical a change. Excesses of all kinds should be avoided; the digestive apparatus should be encouraged to the performance of its duty by the presence of good, well-prepared, wholesome food. Wine, brandy, and malt liquors may not only be allowed, but when used in moderation are extremely useful in averting those debilitating influences which so often prevent the system from repelling disease; but their use should be positively interdicted whenever undue stimulation results.

It is a well-established fact that when the digestive organs of an individual are in a normal condition cholera is rarely developed, but those whose digestion is disturbed readily fall victims to the disease. Experience