FEVER IN THE ARMY
The most serious and threatening feature
of the situation at Santiago after the capture of
the city was the ill health of the army. In less
than a month after it began its Cuban campaign the
Fifth Army-Corps was virtually hors de combat.
On Friday, July 22, I made a long march around the
right wing from a point near the head of the bay to
the Siboney road, and had an opportunity to see what
the condition of the troops was in that part of our
line. I do not think that more than fifty per
cent. of them were fit for any kind of active duty,
and if they had been ordered to march back to Siboney
between sunrise and dark, or to move a distance of
ten miles up into the hills, I doubt whether even
forty per cent. of them would have reached their destination.
There were more than a thousand sick in General Kent’s
division alone, and a surgeon from the First Division
hospital the only field-hospital of the
Fifth Army-Corps told me that a conservative
estimate of the number of sick in the army as a whole
would be about five thousand. Of course the greater
part of these sick men were not in the hospitals.
I saw hundreds of them dragging themselves about the
camps with languid steps, or lying in their little
dog-kennel tents on the ground; but all of them ought
to have been in hospitals, and would have been had
our hospital space and facilities been adequate.
Inasmuch, however, as our hospital accommodations
were everywhere deplorably inadequate, and inasmuch
as our surgeons sent to the yellow-fever camps many
patients who were suffering merely from malarial fever,
a majority of our sick soldiers remained in their
own tents, from necessity or from choice, and received
only such care as their comrades could give them.
Yellow fever and calenture broke out
among the troops in camp around Santiago about the
same time that they appeared in Siboney. Calenture
soon became epidemic, and in less than a fortnight
there were thousands of cases, and nearly one half
of the army was unfit for active service, if not completely
disabled.
The questions naturally arise, Was
this state of affairs inevitable, or might it have
been foreseen as a possibility and averted? Is
the climate of eastern Cuba in the rainy season so
deadly that Northern troops cannot be subjected to
it for a month without losing half their effective
force from sickness, or was the sickness due to other
and preventable causes? In trying to answer these
questions I shall say not what I think, nor what I
suppose, nor what I have reason to believe, but what
I actually know, from personal observation and from
the testimony of competent and trustworthy witnesses.
I was three different times at the front, spent a
week in the field-hospital of the Fifth Army-Corps,
and saw for myself how our soldiers ate, drank, slept,
worked, and suffered. I shall try not to exaggerate
anything, but, on the other hand, I shall not suppress
or conceal anything, or smooth anything over.
Poultney Bigelow was accused of being unpatriotic,
disloyal, and even seditious because he told what
I am now convinced was the truth about the state of
affairs at Tampa; but it seems to me that when the
lives of American soldiers are at stake it is a good
deal more patriotic and far more in accordance with
the duty of a good citizen to tell a disagreeable
and unwelcome truth that may lead to a reform than
it is to conceal the truth and pretend that everything
is all right when it is not all right.
The truth, briefly stated, is that,
owing to bad management, lack of foresight, and the
almost complete breakdown of the commissary and medical
departments of the army, our soldiers in Cuba suffered
greater hardships and privations, in certain ways,
than were ever before endured by an American army
in the field. They were not half equipped, nor
half fed, nor half cared for when they were wounded
or sick; they had to sleep in dog-kennel shelter-tents,
which afforded little or no protection from tropical
rains; they had to cook in coffee-cups and old tomato-cans
because they had no camp-kettles; they never had a
change of underclothing after they landed; they were
forced to drink brook-water that was full of disease-germs
because they had no suitable vessels in which to boil
it or keep it after it had been boiled; they lived
a large part of the time on hard bread and bacon,
without beans, rice, or any of the other articles
which go to make up the full army ration; and when
wounded they had to wait hours for surgical aid, and
then, half dead from pain and exhaustion, they lay
all night on the water-soaked ground, without shelter,
blanket, pillow, food, or attendance. To suppose
that an army will keep well and maintain its efficiency
under such conditions is as unreasonable and absurd
as to suppose that a man will thrive and grow fat
in the stockaded log pen of a Turkish quarantine.
It cannot be fairly urged in explanation of the sickness
in the army that it was due to the deadliness of the
Cuban climate and was therefore what policies of marine
insurance call an “act of God.” The
Cuban climate played its part, of course, but it was
a subordinate part. The chief and primary cause
of the soldiers’ ill health was neglect, due,
as I said before, to bad management, lack of foresight,
and the almost complete breakdown of the army’s
commissary and medical departments. If there be
any fact that should have been well known, and doubtless
was well known, to the higher administrative officers
of the Fifth Army-Corps, it is the fact that if soldiers
sleep on the ground in Cuba without proper shelter
and drink unboiled water from the brooks they are
almost certain to contract malarial fever; and yet
twelve or fifteen thousand men were sent into the
woods and chaparral between Siboney and Santiago without
hammocks or wall-tents, and without any vessel larger
than a coffee-cup in which to boil water. I can
hardly hint at the impurities and the decaying organic
matter that I have seen washed down into the brooks
by the almost daily rains which fall in that part
of Cuba in mid-summer, and yet it was the unboiled
water from these polluted brooks that the soldiers
had to drink. One captain whom I know took away
the canteens from all the men in his company, kept
them under guard, and tried to force his command to
boil in their tin coffee-cups all the water that they
drank; but he was soon compelled to give up the plan
as utterly impracticable. In all the time that
I spent at the front I did not see a single camp-kettle
in use among the soldiers, and there were very few
even among officers. Late in July the men of
the Thirty-fourth Michigan were bringing every day
in their canteens, from a distance of two miles, all
the water required for regimental use. They had
nothing else to carry it in, nothing else to keep
it in after they got it to camp, and nothing bigger
than a tin cup in which to boil it or make coffee.
In the matter of tents and clothing
the equipment of the soldiers was equally deficient.
Dog-kennel shelter-tents will not keep out a tropical
rain, and when the men got wet they had to stay wet
for lack of a spare suit of underclothes. The
officers fared little better than the men. A
young lieutenant whom I met in Santiago after the surrender
told me that he had not had a change of underclothing
in twenty-seven days. The baggage of all the
officers was left on board of the transports when the
army disembarked, and little, if any, of it was ever
carried to the front.
Nothing, perhaps, is more important,
so far as its influence upon health is concerned,
than food, and the rations of General Shafter’s
army were deficient in quantity and unsatisfactory
in quality from the very first. With a few exceptions,
the soldiers had nothing but hard bread and bacon
after they left the transports at Siboney, and short
rations at that. A general of brigade who has
had wide and varied experience in many parts of the
United States, and whose name is well and favorably
known in New York, said to me in the latter part of
July: “The whole army is suffering from
malnutrition. The soldiers don’t get enough
to eat, and what they do get is not sufficiently varied
and is not adapted to this climate. A soldier
can live on hardtack and bacon for a while, even in
the tropics, but he finally sickens of them and craves
oatmeal, rice, hominy, fresh vegetables, and dried
fruits. He gets none of these things; he has
come to loathe hard bread and bacon three times a day,
and he consequently eats very little and isn’t
adequately nourished. Nothing would do more to
promote the health of the men than a change of diet.”
A sufficient proof that the soldiers
were often hungry is furnished by the fact that men
detailed from the companies frequently marched from
the front to Siboney and back (from eighteen to twenty-five
miles, over a bad road), in order to get such additional
supplies, particularly in the shape of canned vegetables,
as they could carry in their hands and haversacks
or transport on a rude, improvised stretcher.
Officers and men from Colonel Roosevelt’s Rough
Riders repeatedly came into Siboney in this way on
foot, and once or twice with a mule or a horse, and
begged food from the Red Cross for their sick and sickening
comrades in their camp at the front.
It is not hard to understand why soldiers
contracted malarial fever in a country like Cuba,
when they were imperfectly sheltered, inadequately
equipped, insufficiently fed and clothed, forced to
sleep on the ground, and compelled to drink unboiled
water from contaminated brooks. But there was
another reason for the epidemic character and wide
prevalence of the calenture from which the army suffered,
and that was exposure to exhalations from the malarious,
freshly turned earth of the rifle-pits and trenches.
All pioneers who have broken virgin soil with a plow
in a warm, damp, wooded country will remember that
for a considerable time thereafter they suffered from
various forms of remittent and intermittent fever.
Our soldiers around Santiago had a similar experience.
The unexpected strength and fighting capacity shown
by the Spaniards in the first day’s battle,
and their counter-attack upon our lines on the night
of the following day, led our troops to intrench themselves
by digging rifle-pits and constructing rude bomb-proofs
as places of refuge from shrapnel. During the
armistice these intrenchments were greatly extended
and strengthened, and before Santiago surrendered
they stretched along our whole front for a distance
of several miles. In or near these rifle-pits
and trenches our men worked, stood guard, or slept,
for a period of more than two weeks, and the exhalations
from the freshly turned earth, acting upon organisms
already weakened by hardships and privations, brought
about an epidemic of calenture upon the most extensive
scale.
By August 3 the condition of the army
had become so alarming that its general officers drew
up and sent to General Shafter the following letter:
We, the undersigned officers, commanding
the various brigades, divisions, etc., of
the army of occupation in Cuba, are of the unanimous
opinion that this army should be at once taken out
of the island of Cuba and sent to some point
on the northern sea-coast of the United States;
that it can be done without danger to the people
of the United States; that yellow fever in the army
at present is not epidemic; that there are only
a few sporadic cases, but that the army, is disabled
by malarial fever, to the extent that its efficiency
is destroyed, and that it is in a condition to be
practically entirely destroyed by an epidemic of yellow
fever, which is sure to come in the near future.
We know from the reports of competent
officers and from personal observation that the
army is unable to move into the interior, and that
there are no facilities for such a move if attempted,
and that it could not be attempted until too
late. Moreover, the best medical authorities
of the island say that with our present equipment
we could not live in the interior during the rainy
season without losses from malarial fever, which
is almost as deadly as yellow fever.
This army must be moved at once or
perish. As the army can be safely moved
now, the persons responsible for preventing such a
move will be responsible for the unnecessary loss
of many thousands of lives.
Our opinions are the result of careful
personal observation, and they are also based
on the unanimous opinion of our medical officers
with the army, and who understand the situation absolutely.
This letter was signed by Generals
Kent, Bates, Chaffee, Sumner, Ludlow, Ames, and Wood,
and Colonel Roosevelt.
In view of such a state of affairs
as that disclosed by this letter there was, of course,
only one thing to be done. The War Department
decided to remove the Fifth Army-Corps at once from
Cuba, and before the middle of August a large part
of General Shatter’s command was on its way
to Montauk Point.
As a result, I presume, of sleeping
without shelter from the heavy dew in the field-hospital
at the front, and over-exerting myself by walking
around the lines of the army in the blazing sunshine
of midday, I was finally prostrated with illness myself.
At three o’clock on the night of Tuesday, July
26, I awoke in a chill, and before morning I had all
the symptoms of calenture, with a temperature of 104.
Calenture, or Cuban malarial fever,
comes on rather suddenly with a chill of greater or
less severity and a violent headache. The temperature
frequently rises to 105, and the fever, instead of
being intermittent, runs continuously with little,
if any, diurnal variation. If the attack is not
a very severe one the headache gradually subsides;
the temperature falls to 102 or 103, and in the course
of three or four days the disease begins to yield
to treatment. In some cases the fever is interrupted
by a second chill, followed by another rise of temperature;
but, as a rule, there is only one chill, and the fever,
after running from four days to a week, gradually abates.
The treatment most favored in Santiago consists of
the administration of a large dose of sulphate of
magnesia at the outset, followed up with quinine and
calomel, or perhaps quinine and sulphur. The patient
is not allowed to take any nourishment while the fever
lasts, and if he keeps quiet, avoids sudden changes
of temperature, and does not fret, he generally recovers
in a week or ten days. He suffers from languor
and prostration, however, for a fortnight or more,
and if he overeats, moves about in the sunshine, or
exposes himself to the night air, he is liable to have
another chill, with a relapse, in which the fever is
higher and more obstinate, perhaps, than at first.
Under ordinary circumstances the fever is not dangerous,
and the worst thing about it is the wretched, half-dead,
half-alive condition in which it leaves one. My
attack was not a very severe one, and in the course
of ten days I was able to walk about again; but the
first time I went out into the sunshine I had a relapse,
which reduced me to such a state of weakness and helplessness
that I could no longer care for myself, and had either
to leave the country or go into one of the crowded
Santiago hospitals and run the risk of being sent
as a “suspect” to the yellow-fever camp
near Siboney. Upon the advice of Dr. Egan, I
decided to take the first steamer for New York, and
sailed from Santiago on August 12, after a Cuban campaign
of only seven weeks.