N ALL the long red history of war, disease has stalked at the heels
of armies. In the present generation it bids fair to cease stalking, at least
at the heels of armies that are scientifically and modernly handled. I have
just been studying the mortality statistics of Vera Cruz for the last sixteen
months. There is a peculiar blank space at the head of the column marked
"Cerebro-spinal Meningitis." For the first six months of 1913 there
were no deaths from meningitis. In July there were three deaths. By December,
in that month alone, there were twenty deaths. The abrupt appearance of this
disease led me to inquire of Major F. M. Hartsock for an explanation.
The appearance of meningitis in Vera Cruz seems
to have been due to Mexico's customary way of doing business. From far up to
the north a drove of Constitutionalist prisoners, infected with meningitis, was
sent south. They were moved right along. No one in authority cared to segregate
them and stamp out the disease. This wretched drove became a perambulating
plague. It was a case, in poker parlance, of "passing the buck."
At last they arrived in Mexico City, where they
promptly infected their prison. Again the buck was passed, and they were
shipped on to Vera Cruz. I do not possess the date of their arrival in the
latter city, but it is patent that it must have been some time in July, 1913,
at which date the death figures suddenly appear in the meningitis column.
There seems to have been no further place to
which to pass them along, so they were finally segregated in prison. From the
first to the twentieth of April, 1914, there were six deaths from meningitis.
It was about this time that the American forces landed and took possession of
Vera Cruz, while General Maas, his soldiers, and released prisoners took to the
brush. And they took their meningitis with them, for there has not been a case
of it since in Vera Cruz.
WHAT
the adventures of this meningitis will be now that it has again
gone wandering may be imagined. The very clothing of these men, as well as
themselves, is saturated with meningitis, and that they will spread the
infection cannot be doubted. At any rate, the times have changed, for the
disease left town with old-fashioned war when modern war marched in.
Smallpox appears to be endemic, rather than
epidemic, in Vera Cruz, while tuberculosis, strange to say, collects a greater
toll of death than all the more serious diseases added together. Here, in the
tierras calientes, or hot lands, where it is so continuously warm that
in a room flung wide to the outer air and every vagrant breeze even a sheet
over one at night is suffocating, the natives crowd into small, unventilated
rooms, weaken their lungs, and fall victims to the White Plague. Malaria, also,
is a never-absent disease, the death line of it rising rhythmically in the
rainy season and falling in the dry season. It, too, by its weakening effect on
its victims, is the cause of their contracting other diseases from which they
perish, chiefest of which, of course, is tuberculosis.
But our army surgeons, wise in tropical diseases
from their service in Cuba, Porto Rico, Panama, and the Philippines, are not
apprehensive of any grave epidemics in Mexico. They have learned much and
rapidly in the last decade and a half, and what they have learned is
demonstrable by statistics.
Typhoid has ever been a grisly monster to north
European and American armies. The Latins and the Asiatics are more immune, this
being doubtless due to a rigid selection, operating through many centuries, by
which typhoid killed off all that were predisposed to typhoid. Thus, whenever
men are gathered together in armies, there will be found a far greater
proportion of nonimmunes among the north Europeans and Americans than among the
Latins and Asiatics.
In 1898, in Florida, the United States mobilized
12,000 men for a period of four months. During this time there were 2,600 cases
of typhoid and 480 deaths from typhoid. Nor is this the whole story. The
soldiers carried the disease with them into Cuba, where many another death
resulted from the four months spent in Florida.
IN 1911, in San Antonio, Tex., 12,000 soldiers were mobilized for four months. During this period there were two cases of typhoid and no deaths. In 1913 and 1914, at Texas City and Galveston, 12,000 soldiers were in camp for many months, during which there was not a single death from typhoid nor a single case of typhoid. In this last long mobilization all other infectious diseases were practically negligible. In the year 1913, in the entire army of the United States, whether stationed at home, in Panama, Hawaii, or the Philippines, there were only six cases of typhoid. This remarkable record, covering so brief a period of time, has been made possible by two things: first, the education of soldiers in camp sanitation and personal hygiene; and, second, the inoculation, or vaccination, of the soldiers against typhoid.
THE
United States was the first country to inoculate its soldiers and
sailors against typhoid, and it is safe to assume, no matter in what other ways
its soldiers may lose their lives in Mexico, that none will die from typhoid.
The serum is hypodermically injected into the arm in a series of three
injections, the intervals between injections being ten days. In a way, the
injectee becomes a sort of peripatetic graveyard. The first injection puts
into his blood the nicely dead carcasses of some 500,000,000 microorganisms
along with all their virtues of deadness which bring about a change in the
constitution of the blood that makes it resistant to future invasions of
full-powered, malignant typhoid microorganisms. With this first injection,
theoretically, the man has had reduced the 100 per cent of his nonimmunity to
typhoid to 32 per cent.
The second injection, ten days later, consists of
a thousand million nicely dead carcasses of the disease. Also, it reduces his
nonimmunity to 8 per cent. The third injection introduces another billion of
the same ably efficient carcasses, and reduces his nonimmunity to zero. In
short, when his body has become the living cemetery of half a billion more dead
bodies that there are live humans in all the world, he has become so noxious to
the particularly noxious and infective typhoid that he may be classed a
positive immune.
IT
IS very easy, the actual process of inoculation. I have had the
pleasure of reducing my nonimmunity of 100 per cent to zero per cent. The first
inoculation was perpetrated in a transport hospital, the second in a captured
academy turned into an army hospital, the third in a field hospital. The stab
of the hypodermic syringe, different from the manner of administering morphine
just under the skin, goes straight down and squarely down into the meat of the
arm for half an inch; but the pang of the stab is no severer. The hurt of the
stab is over the instant the skin is punctured. It is only the nerves of the
skin that protest in either case.
After an inoculation there is no indisposition.
The arm is a trifle sore for several days, and that is all. Some inoculates
aver that they awaken from the first night's sleep with a dark brown taste in
their mouths. In rare cases a mild increase of temperature is noted, reaching
its height some six hours after the inoculation and fading quickly away. I have
talked with a daring one who took the total quantity at one time, and who
stated that the impact was equivalent to a man's fist between the eyes and that
he was not quite himself again for all of twenty-four hours.
But the big thing about the whole affair is the statistics. Individuals do not count. What counts is the results achieve by the inoculation of thousands of men. What counts is the reduction to nothing of typhoid cases in the army hospitals. What counts is the reduction to nothing of the army funerals due to typhoid. Modern war of men against men on the field of battle is now preceded by microorganic wars on the part of our surgeons before ever our men depart for the front. And, Heavens, what tremendous wars are waged by the surgeons! The mortality stuns one when endeavoring to contemplate its totality. When two billion five hundred million microorganisms are slain merely to make one soldier immune against one disease, the sum total of slain microorganisms for a whole army is much beyond mere human conception as the entire visible sidereal system along with what is invisible outside of it. Yet there can be no discussion of the efficacy of inoculation against typhoid. The morbidity and mortality tables of our large-scale army experiments tell the incontrovertible tale.
NO
HEALTHY recruit, having successfully passed the rigid physical
examination, is any longer permitted immediately to join the organization to
which he is allotted. Healthy recruits have a way of coming down with all sorts
of diseases as soon as they change their environment, particularly with
measles, mumps, diphtheria, whooping cough, and scarlet fever. In the old days
so recent, before it was understood, the recruits spread these diseases among
the regiments they joined.
But to-day, ere they are received into the ranks
of their company and regiment, no matter how healthy they may be at the time,
they are forced first to undergo twelve days of isolation. In this phase, the
clean record of the Texas City and Galveston mobilization in such simple
diseases exceeded the record of the previous mobilization at San Antonio. While
all this is a very recent practice, it is a practice wider spread than the
army. No scientific hog breeder to-day, whether importing a prize boar from
another State, another country, or another farm, is rash enough immediately to
turn it in with his herd. It must first undergo its quarantine in a segregated
part of the farm.
The army surgeons to-day are our foreloopers and
pioneers. Not only do they stay at home with the army and make it fit, but they
scout ahead of the army so that its fitness my continue in strange lands and
places. They gather the data on the diseases prevalent in all countries, and
their battles and campaigns are planned and mapped and ready to be fought on an
instant's notice, no matter to what intersection of latitude and longitude the
army may be summoned.
So it is, first, that every soldier up to the
present moment landed in Mexico is free of all disease and immune to such
diseases as smallpox and typhoid; and, second, that a complete and better body
of data has been gathered by our surgeons on diseases in Mexico than has been
gathered by the Mexican Government. Our men start uninfected with a fair
promise of escaping infection when they tread Mexican soil.
Thanks to our discoveries in Cuba some years ago
regarding yellow fever, Vera Cruz was cleaned up. Hitherto, along with Panama
(since cleaned up by us), it ranked with Guayanquil as one of the three plague
ports of the New World. Remains Guayaquil—still revolutionizing—as great a
yellow fever pesthole as ever. We have cleared yellow fever out of Panama, and
it is to be doubted if a single case of yellow fever shows itself among our
troops in Vera Cruz.
YELLOW
fever is so simple a thing to manage. Yet we paid a terrible
death penalty for our ignorance through all the centuries down to just the
other day. We know now that a certain breed of mosquito is the only carrier of
the disease. We know that the way such a mosquito becomes infected is by biting
a human being who is stricken with yellow fever. We know that only in the first
three days that a human being is so stricken is it possible for the uninfected
mosquito to become infected.
The remedy, or rather the preventive, is equally
simple. First, wire screen the yellow fever patient so that no mosquitoes may
be infected by him. Second, fumigate the house in which he lies so that no
possibly infected mosquitoes therein may infect other humans. Third, and purely
a prevision, destroy all mosquitoes in the neighborhood.
In the days of the Paris Commune the
petroleur flourished. To-day, in the American armies on service in the
tropics, the petrolero flourishes. He is the man who spreads oil on all
stagnant waters. The larva of the mosquito cannot hatch in running water, nor
in fish-inhabited water. But it can hatch in a sardine can or in the depression
made by a cow's hoof in soft soil when such receptacles are filled with rain
water.
Not content with their own tropical experience,
our army surgeons in Vera Cruz are reinforced by such experts from the Marine
Hospital Service as G. M. Guiteras and Rudolph von Ezdorf, who have taken
charge of the public health of this one-time death hole of Vera Cruz.
Killing two birds with one stone, or performing two actions with one movement, is a joy forever and cuts down the overhead. It so happens that the same preventative measures for yellow fever are preventative of malaria. Every wire screen about a patient, every drop of oil on the surface of standing water, performs the double duty. Further, purely as a prophylactic measure, each soldier will receive a determined number of grains of quinine daily until such time that Vera Cruz has been metamorphosed into a health resort.
THE
authorities at Vera Cruz did not know as much about their own
water supply as did our army surgeons before our expedition started. They knew
that the source of the water supply, the Jamapa River, was a fast-flowing
stream and uncontaminated. Also, to make doubly sure, they were in possession
of analyses of the water.
Amebic dysentery is of rare occurrence in Vera
Cruz. Smallpox is no longer a thing of which to be afraid. And, further, most
of it seems to have deserted Vera Cruz along with General Maas and his
soldiers.
The United States is large. The
United States army is small. It is scattered here and there in army posts. The
average citizen knows less of his own army than he knows of north and south
polar exploration. As regards the duties and activities of the army surgeons he
does not dream of anything beyond the fact that they keep the soldiers well in
time of peace, and in war dress wounds and amputate limbs. It would make him
sit up and take notice if he could see how complex and multifarious are their
activities here in Vera Cruz.
To commence with, the army is not their only
problem. To keep the army well, they must keep the city well. Not only must
they attend to their own sick and wounded, but they must attend to the sick and
wounded of the Mexican populace and army hospitals, public hospitals, charity
hospitals, women's hospitals, and orphan asylums. Now Uncle Sam is somewhat
meager in such matters. The people of Vera Cruz supported these institutions
before, says Uncle Sam. Therefore, make Vera Cruz support them again. Do you
think I am spending my money like a drunken sailor? Uncle Sam concludes
indignantly.
And our surgeons go and do it, though it takes
all the rest of the army to help. Vera Cruz must pay for those institutions.
But these institutions are two months behind in their bills and salaries, and
there is no money in the city treasury. The last was clean looted by the
officials who had charge of it. Army officers are told off to handle the
collection of taxes. So far as the Vera Cruzan taxpayer is concerned, the taxes
are as they always were. But for the first time in the history of Vera Cruz the
taxes are expended without graft for public service. The back bills and
salaries are paid, and the future bills and salaries are guaranteed.
THE
hotels and cantinas are crowded with thirsty refugees, soldiers,
sailors, and foreign guests, all with a penchant for long, cool drinks. More
ice than ordinarily is consumed. The ice plant is a private enterprise. Its
output is limited. There is not enough to go around. Hotels and cantinas are
cash buyers and pay a premium for ice. Result: (a) the hospitals are
skimped in ice; (b) the surgeons make the suggestion and the army takes
charge of the ice plant, supplying the hospitals first and letting the hotels
and cantinas have what is left.
The naval authorities have already taken
possession of the island and lazaretto Sacrificios, just outside the port of
Vera Cruz. There is no yellow fever at present, but if a sporadic case should
appear, Sacrificios is just the place to segregate it.
I was in the field hospital just after an
operation for appendicitis had been performed on one of our officers. In old
San Sebastian Hospital lie many of the sick of the city and many of the
soldiers that General Maas left behind to fight from the housetops. Many
amputations had been performed, and more were being performed.
Also, I watched the dressing of the wounds of
these poor Federals, and want to register my protest right now that modern war,
for the man who gets bullet wounded, is not at all as romantic as old time war.
Furthermore, a modern bullet, despite its steel jacket which keeps it from
spreading, is a terrifically disruptive thing to have introduced into one's
body. I would far prefer being struck with an old-time bullet than with a
modern one.
It seems that the flight or our long,
sharp-nosed, lean, cylindrical, modern bullet is divided into three flights
much as the spinning of a top is divided into three spins. When first a top is
spun, it jumps and bounces, and bounds about in an erratic way. After a time it
attains equilibrium. This is its mid-spin. It makes no perceptible movement,
and to the eye seems stationary and dead. It is this stage that the small boy
calls "sleeping." Then comes its last spin. It bounds and wobbles
about as it loses the last of its momentum, and it finally lies down on its
side and is dead.
ALMOST
precisely the same thing occurs with the modern bullet. Its
first flight is something like seven hundred yards. During this period, like
the top, it is erratic. It wobbles. If it hits anything while it is wobbling, a
bad smashup is inevitable. In its mid flight, between seven hundred and twelve
hundred yards, it "sleeps." If it hits anything while it is sleeping,
it drills a clean hole. From twelve hundred yards on, losing momentum and
equilibrium, it again wobbles, and this is no time to be struck by it.
In the hospital of San Sebastian I examine the
wound of a finely formed and muscular young man. Midway between knee and thigh
a wobbling bullet had ploughed a path two inches wide and three inches deep. It
was a clean path. Not an atom remained of the flesh that had filled that
groove. You how read this, just draw with a lead pencil a groove two inches
wide and three inches deep and you will more fully comprehend what happens to
human flesh when a high-powered, wobbling bullet goes tearing through it.
THE
effect of such bullets on human bone can be readily imagined.
There is no reason, with modern antiseptic surgery, why a clean-drilled hold
thorough flesh and bone cannot be healed nicely. Unfortunately, such being the
terrific impact and wobble of our high-velocity bullets of to-day, the bone is
shattered for to great a distance into too many minute fragments. The only
thing to do is take off the limb.
When leaving the amputated in the wards of San
Sebastian, I chanced to wander into the hospital chapel. The Chapel of
Bethlehem it had been called once upon a time. It was very old, some two
centuries or so, and was a fine example of the architectural feats achieve by
the Spaniards in brick and stucco in a day when reinforce concrete was unheard
of. Wide arches of incredible flatness and supporting enormous weights were
revealed to be of brick by the spots where the plastering had come off. High
arches spanned deep-embrasured windows, in which some of the ancient, hand-hewn
sashes still remained. The high walls, rising to rafters far above, had caught
the dust of years on the uneven plaster, which gave a fathomless velvet depth
to the surface. The floor was of great, square marble flags.
THE
statues of Christ, the Virgin, and the Saints that had graced the
altar were long since gone. Gone, too, was the altar. Nothing remained save the
lofty alls and cool depth of shadow to suggest that it had been a chapel. And
as I stood in this place whence the worship of the gentle Nazarene had
departed, strong on my vision were the amputated limbs, gaping wounds, and
ruined bodies caused by our wobbling bullets.
Came another picture: I seemed to glimpse a
massed background of machinery and electrical apparatus, of weary-eyed
astronomers searching the heavens, and chemist and physicists dissecting the
atom, of teachers and preachers and great libraries of books. And against this
background, well to the fore, were two groups of men whose brows were the brows
of thinkers, and whose hands worked unceasingly at the making of devices. One
group toiled at the mixing of chemicals and the making of mechanisms for the
purpose of blasting human flesh and bone at longer distances and more
efficiently. The other group toiled likewise with chemicals and instruments,
seeking out new methods and greater knowledge of the constitution of man in
order that they might repair the blasted flesh and bone caused by the devices
of the first group.
SOME
day in the far future pictures will be pained like that, and our
descendants will gaze at them, shake their heads, and laugh at their silly
ancestors, just as we to-day gaze at pictures of witch burning, and shake our
heads and laugh at the silliness of our very immediate ancestors. Man has
climbed far. It would seem that his climb has only begun.
Out across the inner and outer harbors, in the
midst of a fleet of similar monsters, the grim monster, the Arkansas was
a striking sample of the mechanism produced by the war makers. Twelve million
dollars she cost. Her great guns, turned upon Vera Cruz for an hour or so,
could level the city to the ground as a stream of water would level a house of
sand. Magnificent universities have been founded on less than it cost to build
and equip her. The money expended on her would save from the White Plague a
hundred thousand times more lives than she will ever destroy.
OVER
a thousand skilled men are required to man her—skilled men such
as built the Panama Canal and whose skill might well be devoted to making the
Mississippi flood proof. Why, down in the bowels of the Arkansas,
imbedded in the thickest of armor plate, in the battle control station, an
enlisted sailor in the course of describing the new gyro-compass, gave me a
lecture that no college professor could have bettered and that no tyro in such
matters could have understood. Could Columbus or Captain Cook have stood beside
me, and tried to master the details of that intricate compass, I swear their
brains would have flown apart and they would have bitten their veins and
howled.
Quite in contrast, and lying not far away, was
the solitary hospital ship, the Solace. Spick-and-span, and sweet and
peaceful, and very antiseptic she was. I was followed up the gangway by two
young men who just brought off form shore. I walked up the incline on my good
two legs. They came up on their backs in wire-basket stretchers. A long roll of
body-blasted young men had preceded them in the previous two days. Seventeen of
these young men lay embalmed in caskets covered by the Stars and Stripes,
waiting transshipment to their homes in the States. Two more young men lay
dying. Threescore and more in various stages of recovery from body blasting lay
in the bright and airy 'tween-decks wards. A number of amputations had been
performed on them. The careful doctors, waiting, knew there were yet other
amputations to be performed to save the lives of some of the young men.
PASSING
through the wards, one was again struck by the preponderance
of youth. Lord, Lord! They were boys, healthy-bodied and lusty so short a time
before, now lying, lax-muscled, with drawn faces that told all the story of the
body blasting they had endured. One, alive and so lively just the other day,
now with one leg, searched my eyes as if for understanding and sympathy for the
terrible stump that screamed advertisement of the copper he had
received—smashed down, from the back of life, to be a cripple to the end of
his days. Another, a very boy, red-lipped and bright-eyed with fever, smiled
wistfully. There was little hope for him. He was conscious, and, perhaps as men
sometimes will be in such grievous circumstances, he was aware that time would
soon cease for him.
Oh, there was no whining among those lads! They
tell of one, shot in two places, who was fetched aboard crying bitterly and
indignantly. His plaint was that the Mexicans had got him unexpectedly before
he had had a chance to get even one of them. As he said, he wouldn't have
minded his own catastrophe if he had got one of them—only one of them.
THE
beautiful operating room was well appointed. There were
convalescent wards, segregated wards for infectious diseases, and, here and
there, offices and workrooms presided over by experts, such as ear and throat
specialists, eye specialists, stomach specialists. And there was a dentist and
a completely equipped dental parlor.
On deck, under the awnings, we drank long, cool
drinks and gazed across the creamy-crested, pea-green saves to the big looming
battleships, and on to the tiny, half-submerged atolls with lagoons of
chrysoprase, and to the low-stretching breakwater, the lighthouses slim and
white as votive candles, and the old fortresses of Santiago and San Juan de
Ulloa. Suddenly all the panorama narrowed to a sleek gray dove that perched on
the rail a dozen feet away, settled its wings, and preened its feathers.
Somehow, that little gray dove reminded me that,
while a fleet of battleships lay about us, the Solace was the only
hospital ship in the entire United States navy. More than that—I remembered
that she had not been originally designed for the purpose, being merely a
merchant vessel purchased by the Government and made over. Also, I remember
having traveled, years before, in tropic steamers, mere merchant vessels built
for money making, that were far better fitted for the tropics than was the
Solace.
SURELY
the United States, that pays twelve to fifteen million dollars
for ships like the Arkansas, the Texas, and the New York,
should be able to afford the modest cost of a real hospital ship, designed, not
for the making of dollars, but for the alleviation of the ills and injuries
that afflict its sailors and marines.
But there is justification for the existence of
that array of war monsters among which we lay. As long as individuals in a wild
country—say the head hunters and cannibals of the Solomon Islands—carry
killing weapons, even a philosopher, traveling among them, would be wise to go
armed. Neither algebraic nor high ethical arguments are efficacious
dissuadements to a kinky headed man-eater with an appetite. In those Solomon
Islands more than one scientist, for lack of a rifle had had his head decorate
the grass huts and his body served up succulently from the hot ovents.
ON
a coral beach on the windward coast of Gudalcanar stands a
monument to the memory of the "Austrian Expedition." This was a party
of professors. They were equipped to pursue the vocations that obtain in a high
civilization. They carried sextants, barometers, thermometers, artificial
horizons, cameras, and fountain pens. They carried naturalists' shotguns of the
tiniest caliber, butterfly nets, geologists' hammers, and notebooks for all
sorts of records, also certain instruments with which to make skull
measurements of the natives they might meet. But what they did not carry was
Mauser rifles and long-barreled revolvers. They were not equipped for the
anthropophagi they encountered. One man came back from that expedition to tell
the tail, and he was merely a man in the employ of the professors. The column
stands on the beach to mark that once they had been. Their heads remain to this
day up in the bush of Guadalcanar.
As with individuals, so with nations. As long as
certain nations go armed in a wild and savage world, just so long must the
enlightened nations go armed. The wild and savage world, with its silly
man-killing devices, is doomed to pass. But until it passes, it would be
silliness on the part of the enlightened nations to put aside their
weapons.
An international police force and an
international police court will mark the beginning of the end of war. But as
yet these two institutions have not been founded. So the united States will be
compelled to go on building $15,000,000 battleships and training its young men
to the old red profession.
The point is: when wild and savage conditions
make it imperative for a man or nation to go armed, it is equally imperative
for the man or nation to go well armed. Ever has the sword, in the hands of the
strong breeds, made for wider areas and longer periods of peace. In the end it
is the sword that will make lasting and universal peace. When the last savage
nation is compelled to lay down its weapons, war will have ceased. War itself,
superior war if you please, will destroy itself.
BUT in the meantime—and there you are—what would have been the present situation if the United States had long since disarmed? Somehow, I, for one, cannot see the picture of Huerta listening to and accepting the high ethical advice of the United States.
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