LESSON 1
IMPORTANCE AND SCOPE OF MILITARY PREVENTIVE MEDICINE
1-1.
BACKGROUND
a. Since earliest recorded history, military leaders have been aware of the
devastating effects of diseases upon troops. Around 400 BC, Susruta, an Indian
physician, wrote: "All common practice of the enemy under such circumstances is to
poison the wells on the roadside, the articles of food, the shade of trees (shadowy
places), and the field and forage for cattle. Hence, it is incumbent on a physician
marching with troops to inspect, examine, and purify these before using any of them in
case they be poisoned." Later, around AD 400, Vegetius, a Roman leader, wrote:
"large bodies of troops should not camp too long in any one place, since epidemic
disease can arise from corruption of the air and water and can only be prevented by
frequent change of camp. Troops should not camp upon dry hillsides devoid of shade
and in summer should always be provide with tents. One drink of polluted water may be
as potent as poison in starting an epidemic. In periods of great heat, all marching
should be done before sunrise. In winter, little can be expected of the soldier if he is
allowed to freeze. It is the duty of the commanding officer to provide good water, proper
food, and medical attention for the sick." The responsibility of the commander to
provide these essentials is still recognized and emphasized today.
b. Some of the greatest fiascos in military history have been the result of a
breakdown in hygiene and disease control. For example, when Napoleon Bonaparte
sent a force of 22,000 men to suppress a rebellion in the French colony of Haiti in 1803,
20,000 men died from yellow fever. Subsequently, Haiti achieved independence with
little French opposition. Again in 1813, Napoleon invaded Russia with an Army of
480,000. Although he succeeded in taking Moscow, his troops were decimated by
guerrillas disease, and cold injury, forcing his retreat. Only 10,000 men returned to
France. Of the 470,000 men who were lost, only 60,000 were killed in action; the
remainder died of disease and cold injury.
c. The American experience has not been greatly different. During the Civil
War, twice as many men in both the Union and Confederate armies died from disease
as from enemy-inflicted wounds. During the Cuban campaign of the Spanish-American
War, the ravages of yellow fever and other diseases accounted for five deaths for every
combat death. During World War I, for the first time in history, the ratio of deaths from
disease to deaths from combat causes was reduced to 1:1. Although disease is not
longer the major cause of death in combat, it is still responsible for an overwhelming
majority of the hospital admissions and continues to be a major problem.
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