THE SANTIAGO CAMPAIGN (Concluded)

IV. The wrecking of the army by disease after the decisive battle of July 1-2.

The army under command of General Shafter left Tampa on the fourteenth day of June, and arrived off the Cuban coast near Santiago on the 20th of the same month. Disembarkation began at Daiquiri on the 22d, and ended at Siboney on the 24th. On the morning of June 25 the whole army was ashore, and was then in a state of almost perfect health and efficiency. One week later the soldiers at the front began to sicken with malarial and other fevers, and two weeks later, according to General Shafter’s report, “sickness was increasing very rapidly, and the weakness of the troops was becoming so apparent that I was anxious to bring the siege to an end.” On July 21, less than four weeks after the army landed, Colonel Roosevelt told me that not more than one quarter of his men were fit for duty, and that when they moved five miles up into the hills, a few days before, fifty per cent. of the entire command fell out of the ranks from exhaustion. On July 22 a prominent surgeon attached to the field-hospital of the First Division stated to me that at least five thousand men in the Fifth Army-Corps were then ill with fever, and that there were more than one thousand sick in General Kent’s division alone. On August 3 eight general officers in Shafter’s command signed a round-robin in which they declared that the army had been so disabled by malarial fevers that it had lost its efficiency; that it was too weak to move back into the hills; that the epidemic of yellow fever which was sure to occur would probably destroy it, and that if it were not moved North at once it “must perish.” At that time, according to General Shafter’s telegram of August 8 to the War Department, “seventy-five per cent. of the command had been ill with a very weakening malarial fever, which leaves every man too much broken down to be of any use.” In the short space of forty days, therefore, an army of sixteen thousand men had lost three fourths of its efficiency, and had been reduced to a condition so low that, in the opinion of eight general officers, it must inevitably “perish” unless immediately sent back to the United States. Early in August, after a stay in Cuba of only six weeks, the Fifth Army-Corps began to move northward, and before September 1 the whole command was in camp at Montauk Point, Long Island. Of the eighteen thousand men who composed it, five thousand were very ill, or soon became very ill, and were sent to the general hospital; while five thousand more, who were less seriously sick, were treated in their tents. Eight thousand men out of eighteen thousand were nominally well, but had been so enfeebled by the hardships and privations of the campaign that they were no longer fit for active Cuban service, and, in the opinion of General Miles, hardly one of them was in sound health. I think it is not an exaggeration to describe this state of affairs as “the wrecking of the army by disease.” It is my purpose in the present chapter to inquire whether such wrecking of the army was inevitable, and if not, why it was allowed to happen.

A review of the history of campaigns in tropical countries seems to show that Northern armies in such regions have always suffered more from disease than from battle; but it does not by any means show that the virtual destruction of a Northern army by disease in a tropical country is inevitable now. When the British army under the Earl of Albemarle landed on the Cuban coast and attacked Havana in 1762, it lost nearly one half its efficiency, as a result of sickness, in about four weeks; but at that time the fact that nine tenths of all tropical diseases are caused by microscopic germs, and are therefore preventable, was not known. The progress made in sanitary science in the present century renders unnecessary and inexcusable in 1898 a rate of sickness and mortality that was perhaps inevitable in 1762. Northern soldiers, if properly equipped and cared for, can live and maintain their health now under conditions which would have been absolutely and inevitably fatal to them a century ago.

In April last there was an interesting and instructive discussion of this subject, or of a subject very closely connected with this, at a meeting held in the rooms of the Royal Geographical Society, London, and attended by many of the best-known authorities on tropical pathology in Great Britain. Most of the gentlemen who took part in the debate were of opinion that there is no reason whatever why the white man should not be able to adapt himself to the new conditions of life in the tropics, and protect himself against the diseases that prevail in those regions. The popular belief that the white man cannot successfully colonize the tropics is disproved by the fact that he has done so. It is undoubtedly true that many Northerners who go to equatorial regions contract disease there and die; but in the majority of such cases the man is the victim of his obstinate unwillingness to change his habits in respect to eating, drinking, and clothing, and to conform his life to the new conditions.

The chief diseases, both acute and chronic, of tropical countries those which formerly caused such ravages among the white settlers, and gave rise to the prevalent theory that Europeans can live only in the temperate zone are all microbic in origin, and consequently in great measure preventable. We cannot expect, of course, to see them absolutely wiped out of existence; but their sting may be extracted by means of an improved public and private hygiene and other prophylactic measures. A comparison of the healthfulness of the West India Islands under enlightened British rule with that of the two under Spanish misrule shows what can be done by sanitation to convert a pest-hole into a paradise. Indeed, as Dr. L. Sambon, in opening the discussion, well said, sanitation within the last few decades has wrought wonderful changes in all tropical countries as regards health conditions, and the changes in some places have been so great that regions once considered most deadly are now even recommended as health resorts.

Dr. Patrick Manson, than whom there is no greater authority on the pathology of equatorial regions, began his remarks with the confession that in former years, under the influence of early training, he shared in the pessimistic opinions then current about tropical colonization by the white races. In recent years, however, his views on this subject had undergone a complete revolution a revolution that began with the establishment of the germ theory of disease. He now firmly believed in the possibility of tropical colonization by the white races. Heat and moisture, he contended, are not, in themselves, the direct cause of any important tropical disease. The direct causes of ninety-nine per cent, of these diseases are germs, and to kill the germs is simply a matter of knowledge and the application of that knowledge that is to say, sanitary science and sanitation.

The fact that ninety-nine per cent. or more of the diseases that prevail in the tropics are caused by germs was known, of course, to the surgeon-general of our army, and ought to have been known to General Shafter and the Secretary of War. It was, therefore, their duty, collectively and individually, to protect our soldiers in Cuba, not only by informing them of the best means of escaping the dangers threatened by these micro-organisms, but also by furnishing them with every safeguard that science and experience could suggest in the shape of proper food, dress, equipment, and medical supplies. The rules and precautions which it is necessary to observe in order to escape the attacks of micro-organisms and maintain health in the tropics were well known at the time when the invasion of Cuba was planned, and had been published, long before the army left Tampa, in hundreds of periodicals throughout the country. Cuban physicians and surgeons, Americans who had campaigned with Gomez and Garcia, and travelers who, like Hornaday, had spent many years in tropical forests and jungles, all agreed that if our soldiers were to keep well in Cuba they should drink boiled water, they should avoid sleeping on the ground, they should have adequate protection from rain and dew at night, and they should be able to change their clothing, or at least their underwear, when wet. By observing these very simple precautions Dr. Hornaday maintained his health throughout five years of almost constant travel and exploration in the woods and jungles of Cuba, South America, India, the Malay Archipelago, and Bornéo. If our soldiers went to Cuba, or marched from Siboney to Santiago, without the equipment required for the observance of these precautions, it was not the result of necessary ignorance on the part of their superiors. As the Philadelphia “Medical Journal” said, ten days before the army sailed: “The climate and sanitary or rather unsanitary conditions of Cuba have been much discussed, and it is well known what our troops will have to contend against in that island.” The “Army and Navy Journal,” about the same time, pointed out the grave danger to be apprehended from contaminated drinking-water, and said: “The government should provide itself with heating and distilling apparatus on an adequate scale. Sterilized water is cheaper than hospitals and an army of nurses, to say nothing of the crippling of the service that sickness brings.” In an article entitled “Special Sanitary Instructions for the Guidance of Troops Serving in Tropical Countries,” published in the “Journal of the American Medical Association” for May, Dr. R. S. Woodson described fully the adverse sanitary conditions peculiar to Cuba, and called especial attention to the danger of drinking impure water and sleeping on the ground. Finally, the highest medical officers of our army, including the surgeon-general, the chief surgeon of the Fifth Army-Corps, and Dr. John Guiteras, published instructions and suggestions for the maintenance of the health of our soldiers in the field, in which attention was again called to the danger of drinking unboiled water and sleeping in wet clothing on the ground.

In spite of all these orders, instructions, and suggestions, and in defiance of the advice and warnings of all competent authorities, General Shafter’s army sailed from Tampa without its reserve medical supplies and ambulance corps, and, having landed on the Cuban coast, marched into the interior without wall-tents, without hammocks, without a change of clothing, and without a single utensil larger than a coffee-cup in which to boil water.

The question naturally arises, Why? If everybody, without exception, who knows the climate of Cuba warns you that your soldiers must not sleep on the ground, in wet clothing, why not provide them with hammocks, rain-sheets, and extra underwear? If your own surgeon-general and the chief surgeon of your own corps advise you officially that the drinking of unboiled water will almost certainly cause disease, why not supply your men with camp-kettles? I can think of only three possible answers to these questions. Either (1) the War Department did not furnish General Shafter with these articles, or with adequate transportation for them; or (2) General Shafter did not believe in microbes and the germ theory of disease, and regarded the suggestions of medical and other experts as foolish and nonsensical; or (3) the commanding general expected to capture Santiago before his troops should be put hors de combat by disease, and did not care particularly what happened to them afterward. If there be any other explanation of the officially admitted facts, it does not at this moment occur to me.

Some of the defenders of the War Department and of General Shafter seek to convey the idea, by implication at least, that the wrecking of our army was inevitable that it was a sort of divine visitation, which could not have been averted, and for which no one, except the Creator of microbes and the Cuban climate, was responsible. But this theory accords neither with the facts nor with General Shafter’s explanation of them. In his telegram of August 8 to President McKinley, he does not say, “What put my command in its present condition was a visitation of God”; he says: “What put my command in its present condition was the twenty days of the campaign when they had nothing but meat [fat bacon], bread, and coffee, without change of clothes, and without any shelter whatever.” From this admission of the commanding general it is clear that the wrecking of the army was not due primarily to uncontrollable climatic conditions, but rather to lack of foresight, mismanagement, and inefficiency. This conclusion is supported and greatly strengthened by the record of another body of men, in a different branch of the service, which spent more time in Cuba than the Fifth Army-Corps spent there, which was subjected to nearly all the local and climatic influences that are said to have wrecked the latter, but which, nevertheless, escaped disease and came back to the United States in perfect health. I refer to the battalion of marines under command of Colonel Huntington. This small naval contingent landed on the western shore of Guantanamo Bay on June 10 two weeks before the Fifth Army-Corps finished disembarkation at Daiquiri and Siboney. It was almost immediately attacked by a superior force of Spanish regulars, and was so harassed, night and day, by the fire of the latter that some of its officers slept only two hours out of one hundred and fifteen. As soon as it had obtained a foothold it went into camp on a slight elevation in the midst of an almost impenetrable jungle, surrounded itself with defensive trenches, and there lived, for a period of ten weeks, exposed to the same sun, rain, and malaria that played havoc with the troops of General Shafter. On the sixth day of August, after eight weeks on Cuban soil and in a tropical climate, its condition, as reported by Admiral Sampson, was as follows: “The marine battalion is in excellent health. Sick-list two and one half per cent. The fleet surgeon reports that they are in better condition for service in this climate than they were when they arrived South in June. I do not think it necessary to send them North." Almost exactly at the same time when this report was made, General Shafter was telegraphing the War Department that seventy-five per cent. of his command had been disabled by fever, and eight general officers of the Fifth Army-Corps were signing a round-robin in which they declared that if the army were not immediately moved North it “must perish.”

Late in August it was decided that the marines should return to the United States, notwithstanding their satisfactory state of health, and on the 26th of that month they reached Portsmouth, New Hampshire, with only two men sick. They had been gone a little more than eleven weeks, ten of which they had spent in Cuba, and in that time had not lost a single man from disease, and had never had a higher sick-rate than two and one half per cent.

In view of this record, as compared with that of any regiment in General Shafter’s command, we are forced to inquire: What is the reason for the difference? Why should a battalion of marines be able to live ten weeks in Cuba, without the loss of a single man from disease, and with a sick-rate of only two and one half per cent., while so hardy and tough a body of men as the Rough Riders, under substantially the same climatic conditions, had become so reduced in four weeks that seventy-five per cent. of them were unfit for duty, and fifty per cent. of them fell out of the ranks from exhaustion in a march of five miles?

The only answer I can find to these questions is that the marines had suitable equipment and intelligent care, while the soldiers of General Shafter’s command had neither. When the marines landed in Guantanamo Bay, every tent and building that the Spaniards had occupied was immediately destroyed by fire, to remove any possible danger of infection with yellow fever. When General Shafter landed at Siboney, he not only disregarded the recommendation of his chief surgeon to burn the buildings there, but allowed them to be occupied as offices and hospitals, without even so much as attempting to clean or disinfect them. Yellow fever made its appearance in less than two weeks. The marines at Guantanamo were supplied promptly with light canvas uniforms suitable for a tropical climate, while the soldiers of General Shafter’s army sweltered through the campaign in the heavy clothing that they had worn in Idaho or Montana, and then, just before they started North, were furnished with thin suits to keep them cool at Montauk Point in the fall. The marines drank only water that had been boiled or sterilized, while the men of General Shafter’s command drank out of brooks into which the heavy afternoon showers were constantly washing fecal and other decaying organic matter from the banks. The marines were well protected from rain and dew, while the regulars of the Fifth Army-Corps were drenched to the skin almost every day, and slept at night on the water-soaked ground. The marines received the full navy ration, while the soldiers had only hardtack and fat bacon, and not always enough of that. Finally, the marines had surgeons enough to take proper care of the sick, and medicines enough to give them, while General Shafter, after leaving his reserve medical supplies and ambulance corps at Tampa, telegraphs the adjutant-general on August 3 that “there has never been sufficient medical attendance or medicines for the daily wants of the command.” In short, the marines observed the laws of health, and lived in Cuba according to the dictates of modern sanitary science, while the soldiers, through no fault of their own, were forced to violate almost every known law of health, and to live as if there were no such thing as sanitary science in existence.

Governor Tanner, General Grosvenor, and Secretary Alger may declare that the wrecking of the army by disease was inevitable, that Northern soldiers cannot maintain their health in the tropics, and that “when troops come home sick and worn, it is a part of war”; but, in view of the record made at Guantanamo Bay, we may say to them, seriously and respectfully, rather than flippantly: “Tell that to the marines!”

The record of the marine battalion, taken in connection with General Shafter’s admission that his command was disabled by “twenty days of bread, meat, and coffee, without change of clothes, and without any shelter whatever,” seems to show conclusively that the epidemic of disease which wrecked the army was the direct result of improper and insufficient food, inadequate equipment, and utter neglect of all the rules prescribed by sanitary science for the maintenance of health in tropical regions. The questions then recur, Why did not the army have such food, clothes, and equipment as would have made obedience to the laws of health possible? Why should they have been directed by their chief surgeon to boil all drinking-water, to avoid sleeping on the ground, and to change their clothing when wet, if it was not the intention to give them camp-kettles in which to boil the water, hammocks in which to sleep, and clothing enough for a change? The American people, certainly, are both able and willing to pay for the proper support and equipment of their army. If it had cost five million dollars, or ten million dollars, to supply every company in General Shafter’s command with hammocks, waterproof rain-sheets, extra clothing, and camp-kettles, the money would have been appropriated and paid without a grumble or a murmur. We are not a stingy people, nor even an economical people, when the question is one of caring for the men that we send into the field to fight for us. If, then, the financial resources of the War Department were unlimited, and if it had supreme power, why could it not properly equip and feed a comparatively small invading force of only sixteen or eighteen thousand men? Were the difficulties insuperable? Certainly not! It is safe, I think, to say that there were a thousand business firms in the United States which, for a suitable consideration, would have undertaken to keep General Shafter’s army supplied, at every step of its progress from Siboney to Santiago, with hammocks, waterproof tents, extra clothing, camp-kettles, and full rations of food. The trouble was not lack of money or lack of facilities at home; it was lack of foresight, of system, and of administrative ability in the field.

Lieutenant Parker of the Thirteenth Infantry has pointed out the fact that the army was not properly equipped and fed “even after the surrender [of Santiago] had placed unlimited wharfage at our disposal within two and a half miles of the camps over excellent roads." A week or ten days after the surrender, officers were coming into Santiago on horseback and carrying out to the camps over the pommels of their saddles heavy hospital tents for which they could get no other transportation and of which their men were in urgent need. As late as August 13 nearly a month after the surrender the soldiers of the Ninth Massachusetts were still sleeping on the ground in dog-kennel tents, toasting their bacon on the ends of sticks, and making coffee in old tomato-cans, although at that very time there were hundreds of large wall-tents piled up in front of the army storehouse on the Santiago water-front and hundreds of tons of supplies, of all sorts, in the storehouses and on the piers.

The state of affairs in the hospitals was not much better than it had been a month before. In a signed letter dated “Santiago, August 12,” Dr. James S. Kennedy, first assistant surgeon of the Second Division hospital, declared that there was “an utter lack of suitable medicines with which to combat disease. There has been so much diarrhea, dysentery, and fever, and no medicine at all to combat them, that men have actually died for want of it. Four days after my reporting here there was not a single medicine in the entire hospital for the first two diseases, and nothing but quinine for the fever. Yesterday, August 11, a certain regiment left its encampment to go on board ship for the North, and ten hours afterward a private who had been left behind started back to his former encampment to sleep, no private soldiers being allowed in Santiago after dark. On reaching his camp he found ten men abandoned no medicines, no food, no nurses or physicians simply abandoned to starvation or suicide.”

If these statements are not true, Dr. Kennedy should be brought to trial by court martial for conduct prejudicial to good order and discipline, if not conduct unbecoming an officer and a gentleman, in publicly making injurious charges that have no foundation in fact. If they are true, they furnish another proof that the lack of medical supplies and medical attention in the army was due to official negligence and inefficiency. In June and July it might have been urged with some show of plausibility that a sudden and unexpected emergency, in the shape of a wide-spread epidemic of fever, had taken the army by surprise and found it unprepared; but with the coast of the United States only four or five days distant, with uninterrupted telegraphic communication, and with good landing facilities in a safe and sheltered harbor, there was no excuse for a lack of medicines and hospital supplies on August 12 seven weeks after the army landed and four weeks after it entered the city of Santiago.

Defenders of General Shafter and the War Department try to excuse the wrecking of the army by saying that “the invasion of Cuba was not a pleasure excursion,” that “war is not strictly a hygienic business,” that “the outcry about sickness and neglect is largely sensational and for the manufacture of political effect,” and that the general criticism of the management of the campaign is “a concerted effort to hide the glories of our magnificent triumph under alleged faults and shortcomings in its conduct”; but these excuses and counter-charges do not break the force of the essential and officially admitted fact that our army landed on the Cuban coast on June 24 in a high state of health and efficiency, and in less than six weeks had not only lost seventy-five per cent. of its effective strength, but had been reduced by disease to a condition so low that, in the opinion of eight of its general officers, it “must perish” unless immediately sent back to the United States. Secretary Alger declares that management which produces these results “is war”; but I should rather describe it as incapacity for war. If we do not learn a lesson from the Santiago campaign if we continue to equip, feed, and manage our armies in the field as we equipped, fed, and managed the Fifth Army-Corps in Cuba our newly acquired tropical possessions will cost us more in pensions than they will ever produce in revenue.