University Medical College - Scalpel Yearbook (Kansas City, MO)

Page 131 text:

Natinnal Lbuarh-Armg, Zliielh mth Glamp Sanitation BY J. THOMAS PITTAM, M. D., Lecurer on Pharmacy. , 1 HE importance of the medical department of the national guard, as compared with i its other staff departments has been somewhat neglected, but recently the ten- dency 1S to iecognize that department in its true value and give to it more in- ' 1 dependence and power. The statistics of the wars and of the pension department prove that if we could prevent this tremendous and unnecessary loss of life from disease, this country would save in pensions alone in less than twenty years the entire cost of each war. Recent discoveries in sanitation and modern knowledge of bacteriology enable us to eliminate preventable diseases. If a large army be called together hastily in the summer time without proper medical organization, where it can exercise the power of direction and supervision unless it is elevated and fortified with the power necessary to carry out its purposes, there will in a very short time prevail a miserable and wretched condition in that army. It must either have the proper organization or must take the consequences. Every death from preventable disease is an insult to the intelligence of the age, when it occurs in an army it becomes a state crime. This country in the hour of danger expects every soldier if necessary to lay down his life in its defense and honor. It should there- fore give him the best sanitation and the best medical supervision that can be had, and the power to enforce its demands. The medical officer who selects his camp with the foresight of a sanitary engineer and who regulates the camp drainings, and the location of the latrines, who inspects water supplies, food and its preparations, the soldiers' and their cleanliness, and avoids the epidemic of typhoid fever, dysentery and diarrhea which have decimated armies in the past, serves his country better than he who presides over the wards filled with disease, who often through weary days or months of 'suffer- ing, are invalided home or returned to the fighting line in a weakened condition. Ow- ing to the short time state troupes spend in camps of instruction it is difficult to im- press them with the necessity of sanitary discipline, and sanitary organization. The Japanese would never have won that series of brilliant victories unless they had their army in the most magnificent physical condition, and they would not have been in that condition if they had not had the most thorough sanitary government, and medical or- ganization that any army has ever yet had in all history. The medical organization should be the advance agents of an army. The condition of the country from a sanitary standpoint should be known as well as strategically. And if known and used to advan- tage will afford its possessors an advantage over his opponent. Surely, as our citizen soldiers are the backbone of this country and are as good as any in the world, they should have provisions for their health and lives inferior to none in the world. The med- ical officer should be omnipresent. He should be in the front of the army as well as in the rear. He should be with the first screen of scouts, with his microscope and chem- icals, testing and labeling wells so the army to follow would drink no contaminated wa- ter. Every town or hamlet should be examined in its sanitary condition, known in ad- vance of the army, so that contagion and infection, if found, can be isolated and the ap- proaching troups warned. The medical officer should accompany foraging parties and be with the commissariat officers inspecting the various foods, fruits and vegetables sold by the natives along the line of march, long before the arrival of the army, if the

Page 130 text:

Washington, D. C., giving professional and moral qualificationsg if these are satisfac- tory and there exists a vacancy, the Surgeon General will probably order the applicant to report to the nearest military post for examination as to his physical and mental fitness to fill the position to which he aspires. A commission is to be preferred should the applicant contemplate adopting the U. S. Army as a permanent field for his medical careerg should he successfully pass the mental and physical examination, he is issued a commission, with the rank of First Lieutenant, the pay being one hundred and twenty-five dollar per month, after five years' service he is entitled to take the examination for the rank of captain, which pays one hundred and fifty dollars per monthg the ranks of Major, Colonel, Lieutenant Colonel and Brigadier General are successively attained by right of seniority, the Sur- geon General is selected by the President from the ranks of the Brigadier Generals on the active list. To him all reports go, he dictates the policy of the medical department of the U. S. Army and is held responsible for the efficiency thereof. Commissioned officers can be discharged only for cause and then not without the right of trial by court martial. At the age of sixty-two, any officer, if he so desires can retire upon half pay, which amount he continues to draw till his death. All commis- sioned -officers receive ten per cent in addition to their regular pay, for every five years service up to forty per centgg after that there is no increase. Socially, the life of the army officer is not unpleasant, particularly so, while sta- tioned at a large post, here he finds much in the receptions, parties, balls and club to help while away what might other-wise be dull and tedious hours if stationed at a Western or so-called frontier post. Much time can be pleasantly spent in pursuits of the rod and gun. Everything considered, I should say that the life of the army surgeon c-ompares favorably with that of the physician in private practice. 'Tis true, he can never aspire to the high honor of being great, as a physician or surgeon for the limi- tations that naturally surround his sphere of work preclude the possibility of his being able to compete with his more favored brother engaged in private practice, the word compete is used here with reference to opportunity, it is obvious that the physician in private practice in a large city with modern hospitals, large clinics and a large clien- tele to draw from, has a much better opportunity to develop his skill and perfect his technic than has the- army surgeon in his more restricted field. I admit that a few army surgeons have carved their names high upon the altar of fame, but these are the exception and n-ot the rule, a large majority of the truly great, in medicine and surgery, came from the ranks of the physicians in private practice. In ch-oosing one's life work, no matter what the sphere, one important point should be constantly born in mind, viz., that of personal adaptabilityg certain attributes -of character are peculiarly requisite in one to insure a successful military careerg chief among these may be mentioned a thorough command of one's self, for often times, or- ders from a superior officer, harshly given, will prompt the inner feeling to revolt and require all the -strength of a strong nature to subdue. He should next ask himself: Would he be content to lead a roving life with no fixed place that he could call home? Possessed of thorough self-command, and the last question answered in the affirma- tive, I think, other things being equal, no young man will make a mistake in choosing a medical career in the U. S. Army.

Page 132 text:

1 1 1 1 1 1 1. 1 l, 1 11 1 1 1 1 1 1 1 1 1 1 1 1 11 1 1 111 .1 11 .1 11 1 11' i1 '1 111. 11.1 11111 ,11 E. 1 L '1 1, 1 1 1 1 1 1 1 1 1 1 1 1 food was tainted or fruit over ripe or water required boiling, notices should be posted to that effectg and such should the respect and discipline of every soldier from com- manding officers to the file and rank that obedience to all orders be absolute. The hospitals should be used for the care of casualties caused by shell and shrapnel. And not be loaded to their capacity with preventable diseases, such as diarrhea, dysenteries, typhoid fever, which are the result of improper feeding and drinking and neglected sanitation. These diseases have brought more campaigns to disastrous termination than the strategies of opposing generals or the bullets of their followers. Armies will have their deaths, their killings and their tragedies but they are legitimate tragedies of war, and should not be murders through criminal neglect. Our government will not tolerate the maintenance of a large army in time of peace, its presence being considered a menace to republican institutions, it is, therefore, more necessary to us than to any other country in existence to have the best equipped and most efficient medical department of any service in the worldg a department whose elasticity will be sufficiently great to permit of its rapid extension in the emergency of war. ' At such times, of course, it must draw its working force from civil life. And if the best element of the profession at large is to be enlisted, it is only fair and just to that profession, that it should receive due recognition. The instruction and examination of members of the hospital corps of the national guard is very lax. And the instructions to the rank and file is almost nothing. And the condition is not to be wondered at where we consider that this government pays the medical department nothing for their serv- ices. And in many instances supplies such as medicine, bandages and instruments must be paid for out of their own purse. Some of the states are positively niggardly when it comes to maintaining their citizen soldiery. In 1894 the French in their Madagascar campaign lost seven thousand- men out of fourteen thousand from preventable diseases, most of them could have been saved with proper sanitary and medical provisions only twenty-nine died from bullets. I mention this bit of history to impress upon you if pos- sible the tremendous importance of fighting the silent foe that is always present as well as the open foe in the field. Until the surgeon general department is lifted to a plane far above its pres-ent level and is given power to enforce its prerogatives its fight against the silent foe -that has killed eighty per cent in every war in which America has ever engaged cannot be crowned with victory. It is not for the officer but for the file and rank who brave the brunt of the battle that the appeal should be made.