T n -^'^■■^ :l ;^ INTERNATIONAL SERIES, EDITED BY LIEUT.-COL. ARTHUR L. WAGNER, Assistant Adjutant-General, U. S. Army ; late Instructor in Art of War at the U. S. Infantry and Cavalry School, Fort Leavenworth, Kansas. THE Hygiene of the Soldier in the Tropics, BY F. BUROT, Medecin principal de la Marine, Officier de la Legion d'honneur, Officier d'Acadeniie, Laur^at de I'lnstitut, AND M. A. LEGRAND, Medecin de 1'^ classe de la Marine Chevalier de la Legion d'honneur, Laureat de I'lnstitut. TRANSLATED BY CAPTAIN GEORGE W. READ, 9th U. S. Cavalry. No. 7. KANSAS CT"" ■ : '-BE! ivISHING c le Street. PfOLOGY UBRARy Copyright, 1S99, By HUDSON-KIMBERLY PUBLISHING CO. Kansas City, Mo. TABL.EI OF GONTEwNTS. Page. Introduction Chapter I.— HABITATION ^^ I.— Location of Troops in the Colonies 1^3 II.— Situation of Barracks and Posts 2o 2S III.— Colonial Habitations Chapter II.— ALIMENTATION ^^ I.— Nutritive Value of the Ration 34 II.— Solid Aliments '^^ III.— Liquid Aliments ^^ IV.— Potable Water •" ^^ Chapter III.— CLOTHING AND EQUIPMENT 58 I.— Rules of the Hygiene of Clothing 59 II.— The Different Articles of Clothing. . ., 61 III.— Maintenance of Clothing 66 Chapter IV.— MILITARY LIFE 68 I.— Occupations of the Soldier 68 II. — Fatigue Duties and Work 72 III.— Bathing. 80 IV. — Amusements and Repose 81 Chapter V.— MEDICAL SERVICE 81 I. — Medical Permniirl 81 II. — Hospitals and Infirmaries 90 III.— Materiel of the Health Service 92 IV.— Repatriation of the Sick 94 Chapter VI.— SANITARY POLICE 104 I.— Commission of Hygiene 104 -85169 4 Tahle of Contents. Page. II. — Administrative Measui'es 106 III. — Hygienic Measures 112 Chapter VII.— SPECIAL MEASURES FOR EXPEDITIONS 120 I.^Colonial Expeditions 121 II.— Selection of Troops 124 III. — Convoys and Supplies 128 IV. — Sanitary Service 134 V. — Hygienic Conduct of Operations 164 Chapter VIII.— HYGIENIC PRINCIPLES OF A COLONIAL ARMY 174 I.— Recruitment 177 II. — Organization 188 III. — Departure for the Colonies 205 IV.— Length of Sojourn 206 Conclusions 209 PREFACE. The importance of a knowledge of Militarv Hygiene on the part of officers in command of troops has long been recognized, and was painfully emphasized during the war with Spain by the heavy losses of many volunteer organiza- tions that, remaining in home camps, did not see a hostile flag or hear a hostile shot. Not only is Military Hygiene a subject for serious consideration when our troops are sta- tioned in a climate to which they are accustomed, but it becomes doubly so when they are called upon to serve in tropical regions whose climatic and hygienic conditions are new and strange, and where no enemy is so formidable as the endemic diseases. The climatic conditions of Cuba. Porto Rico, and the Philippines are not unlike those of Madagascar, Tong-King, and Mai^tiniijue; and the observations, experience, and de- ductions of the medical officers of the French Army in those regions are accordingly deserving of careful attention. It is reasonable to conclude that anything good or bad for a French soldier will be beneficial or injurious to an American soldier serving under like conditions, and the editor there- fore ventures the hope that by placing this translation in the hands of his brother officers he may be, in some degree, conferring a benefit upon our military service. Headquarters Department of Dakota, St. Paul, ^linn., June la. 1S09. Hygiene of the Soldier in the Tropics INTRODUCTION. Much has been wiitten of late years upon (ffilonial hy- giene. Numerous authors have tried to state precisely the rules to be followed in order to preserve the health of the soldier in hot countries. It would suffice to refer to their works, if we did not hope to present new ideas and to ex- plain, in concise form, the ensemhie of the measures capable of protecting the soldier against the diseases which Pro^ fessor Brouardel has so happily called the maladies evitables. The ideas which flow from our preceding studies permit us to face the danger and combat it rationally. Among the means of protection and defense, the whole- of which constitutes the Hygiene of the Soldier in the- Tropics, it will not be surprising if we accord first place to those which seem to us more particularly shown to protect the European soldier from telluric action. The soil is the most important factor, for it is the receptacle of the germs which provoke the principal endemic disease: paludism. Water comes in second place; it bears the microbes of dys- entery, of cholera, of typhoid fever; it is through it that epidemics are propagated. There are other morbid causes which it is well not to neglect. The sun aggravates most of the diseases and pro- duces some of them. The effect of high temperatures, of 8 I)ilrodi(clion. humidity, of cold, of iusufficieut or bad nourishment, of overwork, is only too real not to attract our most particular attention. The scarcity of medical attendance, the vicious organization of the sanitary service and of urban hygiene in the colonies, must also l)e taken into account. The causes inherent to the connti'y itself are not the only ones which produce mortality among the colonial troops; there are others peculiar to the individual who ar- rives for the first time in a tropical country, whether to re- main in garrison or to take part in an expedition. If the soldier is too young, if he has not a robust consti- tution, he will be an easy i)rey; but if. on the contrary, he has been selected strictly with a view to the trials he will have to bear, he will be able to become refractory to the morbid influences. There arises in this connection the much debated question of the recruitment and organization of the colonial army. We propose to discuss it with all the care it merits. Humanity and military interest are in accord in de- manding, among the contingents destined for service in our possessions beyond the seas, a preparatory selection, which has not yet been made. There should no longer be allowed to go, even voluntarily, by the side of the veterans of the Sahara, of the Soudan, and of Chinese India, young French- men entirely disarmed in the face of that enemy called the torrid climate. All should be professionals, inured to military- life, capable of prom])t and easy adaptation Jo the colonial existence, and suri-ounded. in addition, by all the j^uaranties necessary to the pi-eseryation of their health. It seems to us ])ossible 1o group in eight chapters all the hygienic; principles ajiplicable to the colonial troops, in the following order: 1st, Habitation; 2d, Alimentation; 3d, Clothing and Equipment; 4th, Military Life; Stli, Med- Introduction. 9 ical Service; 6th, Sanitary Police; 7th, Special Measures for Expeditions; 8th, Hygienic Principles of a Colonial Army. It is a question of preparing a veritable Code of Health, and our ambition will be satisfied if we succeed in showing the absolute necessity, in the colonies, of a rigorous hygiene for both individuals and communities. University CHAPTEK I. Habit \.tion. It has been said by J. Roeliard that an expense incurred in the name of hygiene is an economy. This is a truth which cannot be too well borne in mind when it is a question of providing the colonial soldier with a lodgment to protect him against telluric influences, inclemencies, and foreign contaminations. To keep in good health in a warm country, it is neces- sary to be well housed and suitably installed. There are few of our colonies where it has been possible, from the beginning, to prepare a good installation for our troops, and there are none where hygienic reasons have exclusively determined the choice of the site. At Martini(jue, Fort-de-France is built upon a marsh, while all around there are heights much better adapted for the establishment of Europeans. Saiut-Pierre is built upon a contracted shore at the foot of the mountains; the pollu- tion of the soil breeds dysentery. In Guadeloupe, Pointe-a-Pitre is built upon marshy ground and at the bottom of a funnel; the uuhealthfulness of this town is well known. Basse-Terre is better situated and has the advantage of having in its vicinity Camp Ja-^'ob, utilized so happily for the health of soldiers and officials. French Guiana has presented, at certain times, a worse sanitary condition than that of Dutch and British Gui mas, jjlaced in the same conditions as to soil and climate; this difference can be attributed only to insufficient drainage^ and to the imperfection of the habitations reserved for Europeans. 12 Hygiene of the Soldier in the Tropics. In Senegal, the town of Saint-Louis, built upon an isle of sand, has long been deprived of potable water of good (luality. Gor^e is only an islet, relatively healthy. Dakar can become a healthy town with an abundance of water. The post of Thies, situated on the metaled road from Cayor, is hygienically placed at an altitude of ()5 meters, far from all marsh, and is one of the best established. Our establishments in the Soudan. Guinea. Cote-d'- I voire, B^nin, and Kon'go, leave much to be desired. In Indo-China, great progress has been made. The town of Saigon, built over arroyos, has become habitable, thanks to a good system of canals of potable water, to large clearings, to the numerous plantations, to better-u'ulerstood constructions, and to the wholesomeness of the soil. Tong- King will profit by the lessons of the past and will become a prosperous colony; if the heights are infested with palu- dism, while the Delta is destitute of malaria, the reason is that the Delta is admirably cultivated and the heights still uncultivated. In New Caledonia, the town of Noumea, built upon a marsh, is exempt from paludism. but too often visited by typhoid fever and dysentery, which find in the geological formation causes favorable to their development. Tahiti is a volcanic island which would gain in salubrity if the habitations, more hygienically constructed, had be;'n buiU a few hundred meters above the sea-level. At RcMiiiion. I he |>:iluerb town. Hygiene of the Soldier in tie Tropics. 13 In our new possession, Madagascai-, all points of the coast are unwholesome; this has long been known. The heights are habitable and capable of colonization, and, now that we are masters of them, we would be guilty not to utilize them. In the colonies, more than elsewhere, when it is a ques- tion of habitation, the first care, when possible, is to select the site judiciously; in the second place, the best situation for barracks and posts should be studied; finally, it is im- portant to regulate in all its details the installation of the buildings. § I. Location of Troops in the Colonies. Our troops in the colonies usually live in the towns and our colonial towns are almost always located upon the l.t- torah There the troops are continually exposed to attacks of paludism, inevitable in the lowlands adjacent to the mouths of great rivers; to yellow fever, the endemic of the shores; to the possible importation, through commercial relations, of all the plagues coming from Europe, Asia, Africa, and America; typhus, cholera, etc. In the great colonial centers, they are also exposed to the diseases of the civil population, European and native. The English, those masters in the art of colonization, have, for a long time, understood the necessity of removing their soldiers from the littoral, and to this measure should be attributed, in great par-t, the diminution of mortality among them. The Dutch have imitated them, and seem to have derived important advantages from this hygienic measure. It is proper, in this point of view as in many others, to profit by experience and to utilize the exami)les set us by powers possessing, like ourselves, an extensive colonial domain. 14 Hygiene of the Soldier in the Tropics. ENGLISH STATIONS. We cannot do better than to take a glance at the hy- gienic programme carried out in the colonies, by our neighbors across the Channel. British India. — In Hindoostan, the English, for a num- ber of years, have established Health Citi('f<. which they also designate Summer Stations. The point demonstrated is that the pure air cf the heights has preserved the lives of thousands of soldiers. Tables of mortality prepared for European soldiers prove how much easier acclimatization has become. To- wards the middle of this century the European troops serv- ing in India, although better cared for than during the wars of the past centui-y. lost each year one man in fifteen : but since then the rate of mortality has constantly decreased. India is one of the hottest colonies of the earth ; the line of greatest mean heat — the equator — pas-ses immtdiately to the south of the peninsula and the isothermal line ()f 24 degrees bends around the northern plains, running along the first swellings of the Himalayas. The annual variation from one extremity of India to the other, nioie than .3.(100 kilometers in length, is only .5 degrees centigrade, if the diversity of altitudes is disregarded and all stations are brought to the sea-level. To obviate the serious inconvenience of these high temperatures during the summer and the depressing and febric a<;tion of the coast climate, the English have estab- lished, near the large towns of the littoral, secondary towns. which are used .as summer residences. These are not, I»roperly speaking, sanatoria for the cuie of invalids, but are stations of preservation. On the northern frontier, the Himalayan chain, a for- midable barrier between India and Thibet, ofifers on its Hygiene of the Soldier in (lie Tropics. 15 Indian slope many favorable points for the establishment of health cities and important military posts. In southern India, the Western and Eastern Ghauts, gradually rising in terraces, from the narrow littoral to the ledge of a plateau 1.000 meters high, and joined together by the transversal chain of the Nilghiris or Blue Mountains, present etiually, at a variety of altitudes, numerous sites capable of being utilized as summer resorts and sanitary stations. The question arises at the outset of connecting the selected points with the ports and principal centers by easy means of communication and of making it a study to eventually secure the development of these nascent towns. PRINCIPAL STATIONS IN INDIA. Altitude. Presidency of Bombay : I'oona 503 meters. " ' '' Matheran 740 '' " " Mahabalechwar or Malcompet 1347 " of Bengal: Darjeeling 2250 '' " of Madras: Bangalore 924 " " " Outakamonnd. . . .2200 '* Punjab: Dharmsala 1950 " » Dalhousi 2243 " Simla 2160 Koumaon: Almora 1815 " Indian slope of the j Ranikhet 1650 ' Central Himalayas: ( Landoui- -19i) Ceylon: Nouvera-Elia. . . .1890 '• Pooncu with an altitude of 563 meters, connnands the region of the sources of the Bhima, and is one of the large cities of India ; from June to November, when the monsoon blows and the rain falls in torrents, it becomes the tem- porary capital of the presidency of Bombay. The station Matlieran is situated, at an altitude of 749 meters, upon a butte completely separated from the chain 16 Hygiene of the Soldier in the Tropics. of the Ghattes by the erosion yalley traversed by the river Oulas; in less than four hours the inhabitants of Bombay can to-day reach the summit of the hill. Mahahalechwar, one of the most frequented of the health cities of the Western Ghattes, is found in the district of Satara. at an altitude of 1347 meters. In spring it becomes the residence of most of the high officials of Bombay. Dur- ing the warm season Mahahalechwar is very agreeable; it was founded in 1828, by a governor of Bombay, Malcom, and one of the villages of the station is named Malcompet. From 10 to 15 kilometers from Madras, the two syenitic huttes called the 3Ionts Saint-Thomas (where the governor's villa, noted for its gardens, is located) serve, like the pla- teaux of Mysore, as summer residences for Europeans. Ban- galore, with an altitude of 924 meters, is considered one of the most healthful stations of the region; many English are established there. South of Mysore, the town of OutaTcamound, the prii- cipal place of the Nilghiri, is of modern origin; its pleasure- houses are scattered over considerable space at a mean altitude of 2200 meters; to the east the escarpments of the Dodabetta, the Hotahiri, and the Kounour are likewise peopled by Europeans. Outakamouiid, following the ex- ample of the other English towns of India, has not less than three trial gardens for the culture of exotic species; these gardens are elevated at different heights upon the slopes of the plateau. The lirst cinchona plants were imported from Peru in ISdO, and within a few years 2r),(l()() of these plants w^ere prosjxn-ing in the environs of Outakanionnd. Now vast forests of quin-quinas have largely replaced the grasses and jungles of the plateau, and furnish the British Army an abundant supply of febrifuge. Near Calcutta. Ifazarihagh, a station renowned for its Hi/f/irnr of the Soldier in I lie Tropics. IT line air, is constantly gaining in inipditance as a summer resort for the English merchants of Calcutta who are kept in the neighborhood by business atfairs. Ddrjediinj is situated on the narrow edge of a moun- tain, and has an altitude of from lMKMI to iMOd meters; 1800 meters below lies the gorge through which tlow the waters of the Grand Kandjit. This health city is (iSO kilometers from the Anglo-Indian <-a})ital ; the journey can be made in twenty tour hours by a railroad running from Calcutta to the foot of the mountain. The climate is very humid, the rains being almost (hiily. Like almost all the health cities of India. l)arj«^romontory of the last Hima- layan chain, the British Government has founded a health city for its employees and soldiers. Dalhovsi, at an altitude of 2243 meters, makes a su]»erb observatory, whence the view extends over the beautiful valley of the Ravi, the mountains of Kangra, and the neighboring plains of Lahore and Amritsir. To the southeast, a buttress of the Dhaola- Dhar or •'\Miite Mountain'' bears the pleasure-houses of Dluirmsaia, scattered between 1350 and 1950 meters along the mountain slopes. This other health city, which has replaced an anticjue Ihahmin sanctuary, has become the chief place of the entire Kangra district and the center of numerous tea plantations. Simla (35,000 inhabitants), situated at an altitude of 21G0 meters, upon the Indian slope of the central Hima- layas, occupies a separate domain between the provinces of the west and central Himalayas. Simla was founded recently, but the advantage's (tf its position and the caprice of a viceroy of India have made it the summer cai)ital for the whole empire. As soon as the hot season comes on, the routes leading from the plain t<»wards Simla are covered with convoys and (Mpiijtages carrying to the health city the high functionaries of Calcutta, followed by their employees; even some of the jtrincipal state officials emigrate every year at this lime fiom the one to the oilier city. To the south of Simla, whose fame dates back scarcely thirty years, several other health cities have been built ui»on the slopes or ci'own till* liills. These are Soiitxifhnii^ Ko^iaoti, Diujchdi, and k'litlfi, which are at the same time military stations. The island of Ceylon, which likewise foiins a pait of the Hygiene of the Soldier in the Tropics. 19 great Anglo-Indian Empire, and is sejtarated from the Dec- can only by a narrow and shallow strait, merits mention from the point of view now occupying our attention. Un- healthy in the lowlands to the north of the island, in the plains, and along the shores which border the littoral, where the heat is insupportable in the hot season (the mean annual temperature being 27° to 28° Tentigrade), the climate of Ceylon is very salubrious and most agreeable in the moun- tains of Pedrotallagalla and Samanala (Adam's Peak), whose summits attain 2200 to 2500 meters. The Portuguese, the former possessors of the island, and aftei- them the English, have established their summer residences at points varying in altitude from 1000 to 1500 meters. In the hot season the Europeans and officials desert in a body the ports of Col- ombo, Pointe-de-Galle, and Triucomalee, repairing to Kandy, 518 meters in altitude, on a bend of the only river of the island, the Mahavila. When their business ])ermits theiu to go farther away, they jiass the hot season at Nourfm-Elld. which has an altitude of 1800 meters. It was very natural for the English to seek to establish these centers in the mountainous regions and upon the ad- vanced promontories of the Himalayas, where it would be possible for them to recuperate their health, compromised by a sojourn in the burning plains of the Ganges and Indus, and to recover their strength, enfeebled by so debilitating a climate. Britisli AntiUes. — In Jamaica, during the warm season, the English send their European troops to stations estab- lished at different points of the Blue ^Mountains, where the temperature is from 12 to i:*> degrees lower than in the towns of the littoral, like Kingston, and where hygienic conditions are excellent. The forests of Hope Gardens enjoy a great reputation 20 Hi/giene of the Soldier in the Tropics. for liealthfuliiessj. There has been established at Neurastic, at an altitude of 1158 meters, a camp of preservation, to which is sent the greater i>art of the garrison during winter and in times of epidemic. Western Africa. — A recent fact well shows the interest taken bv the English in the solution of this problem of colonial hygiene. They have resolved to establish a sanatorium for the West Coast of Africa, as a monument to the memorv of Prince Henry of Battenberg; but they have not yet defi- nitely decided upon its location. Some propose to establish it upon the continent itself, choosing an elevated locality between Cape Coast and Elmira; others wish to select an appropriate site on the Gran Canaria. At the present time, the last solution would seem to be much preferable to the first, for the (han Canaria is much more accessible to the Europeans who live upon the West Coast of Africa than any locality in the interior. Moreover, it is reached by sea, avoiding all the dangers and difficulties of a journe}- across a pestilential country. Besides, the Gran Canaria, except in certain respects, is a very healthy place; it also oft'ers all the alimentary resources of a civilized country, conditions which could not bo found in the interior of Africa. A temporary stay in a subtropical climate like that of the Gran Canaria would be admirably suited to anaemic and paludal persons, and would perha])s be even preferable to an immediate return to the cold and humid regions of northern I^hiiopc. AMien Ihe lihick Continent has been bcllcr explored, when routes and railroads have been established, it will not be imi)ossil)le to ha\(' in (lie interior, far from the marshes of the coast, sanitary staticms whicli can be it'ached in a few hours. /Iill/lcnc iif ihf Soldier in fhr Tropins. 21 DUTCH STATIONS. In their colonies in tlie Snnda Isles, tlie Dntcli have likewise established sanitary stations. At Java, to the sonth of Anibarawa. upon the ttrst slopes of Merbaboe, at an altitude of 574 meters, is found the town of Salatii/a, much freiiuented during the warm season; the climate is very aj,^reeable and the view magniflcent. T()S(tri, at an altitude of ITSd meters, is the principal station of eastern JaAa; situated at an angle of an epaul- ment of the T«Migger, it is much frecpiented by European ottirials and merchants on account of its climatic conditions. •Java possesses several other sanitary stations at alti- tudes varying from lOTO to iSdO meters, situated in well- chosen places, in the midst of a luxuriant vegetation; such are the sanatoria of Sindang Laya, lluitenzorg. Tchiodas, and others. The mortality of Europeans in Java is to-day ten times less than in the last century. Hygienic rules are more carefully observed; sites for haltitations are chosen in healthy places, and the stations for summer residence, situ- ated at various altitudes, permit a graduation of climate for valetudinarians and convalescents. Nevertheless one must know how to protect himself, by a. strict rpijime, against certain diseases, particularly beriberi, which now and then commits terrible ravages upon soldiers of every nationality com])osiug the colonial aiiny of Holland in the Insulinde. FRENCH STATIONS. In one of the French Antilh's, (luadaloupe, the soldiers are \\o\ (juartered habitually at Hasse-Terre, nor at Pointe- .a-Pitre, but at ('(iinp Jnrnh. It is the only one of our jxtsses- sions where it has been dared, u]> to the present, to openly 22 Hygiene of ihe ^Soldier in Ike Tropics. break away from the customs of Old Europe. In fact, Guadaloupe has possessed, since 1841. Camp Jacob, situ- ated at an altitude of 545 meters, above Basse-Terre and at the foot of the sulphur mine. The creation of this camp, due to the initiative of Admiral de Mosses, has been of con- siderable service, and has resulted, from a hygienic stand- point, in great progress. The mortality has become very light since the day it was decided to place the troops there. At Martinique, the occupation of Balata, since lSt>9, has been only temporary and subordinated to circumstances. At Balata. however,- as at Pitons. the benefits of altitude are lessened by the defective installation of the huts. As for Senegal, the dissemination of the white troops takes place, for the garrisons of Dakar and Saint-Louis, only during the winter. Tlfe chief place of our possessions in Guinea, Konnhri/, seems to be happily chosen. The first buttresses of the Fouta-Djallon have been pointed out as relatively healthy. It ai»])ears that beyond Abomey there is a fertile country, favorable to European colonization and with an altitude of from 400 to 500 meters. In Kongo, after having ciossed the terraces traversed in cascades by the African rivers, Stanley and De Brazza found healthy ])lateaux wheic it would be possible for- the European to live. In Indo CliiuM. at Reunion, and in Madagascar this question becomes of still moi-e capital imj)ortan uieters, Salazie is a veritable sanatorium, where men already convalescent go to complete their cures. Soint-FrdnQois is rather a sum- nuM- station for the soldiers; sitimted on the flank of the mountain which overlooks Saint Denis, and three hours from the latter town, with an altitude of al»out 4()(> nutters, it possesses well-installed huts. This station, at a moderate altitud(^ and in ]>i'oximity to the chief place, would be found well ada])ted to accommodate the gairison permanently, like ('amj> Jacob in (}uadalou|>e. Miiddfiasrar. — In our new possession nothing would be more useful than to (establish sanitary stations for our f ro<»]»s. rpon the coast thei-e are no healthy points, with the possible excei)ti(irrad-s aiid Posts. The benefits of altitude are lost if care is not taken at 26 IJygiene of the Soldier in the Tropics. the outset to remedy the inherent defective conditions in geological formation or in the nature of the vegetation. At Baria, in 1878, the establishment of a sanatorium on Nin-Din mountain was a complete failure; the hill not hav- ing been sufficiently prepared by axe and fire, the jialudal or dysenteric patients taken there and quartered in the bar- racks, which were also defective, all felt an aggr.avation of their condition. In Tong-King, on the road to Langson, the healthful- ness of the posts differs essentially, according to the condi- tions under which they have been established. The pre- cautions to be taken may be stated as follows: Avoid hills where heaps of organic matters in decomposition are found; choose in preference grassy plateaux ; make the site healthy at the outset by clearing the trees, burning the brushwood, ramming the soil, and sodding. If these conditions are not fulfilled, the mountain, in spite of its lower temperature, will be inferior in healthfulness to a nmrshy but well-cultivated plain, such as is found in the Tong-King Delta. It is not always possible to place troops nj)on high ground and it is often necessary to be resigned to (]uartering them in the plain. In this case special care should be taken in choosing the ground and in cleaning u]> the soil so as to diminish as much as ])ossible its hainifulness to health. Humid ground, rich in organic matter, should be rejected. On the contrary, thick beds of sandy ground containing little soil should be sought. Land fonned of hard limestone, of primitive rock, will be excellent if care is taken to level the basins in whicli mineral ;inromoting more efficacious measures against unhealthy habitations. Ke- calling the Persian ])roverb, "NMiere there is neither air nor light, the doctor often enters," the eminent professor de- clares that infectiarati()n of store-rooms must not be forgotten, nor the kitchens; laundries, paved with tlag-stones and pro- vided with an abundance of water, with impermeable con- duits to carry the dirty water outside the bairacks. The places of confinement for discipline sliould never be obscure and unhealthy. Finally, a bath-house with a sufficient number of wash- stands on the galleries will complete the cnscmhle of hygienic barracks in the colonies. TEMPORARY HABITATIONS. Temporary use can be made of houses, temples, pagodas, factories, store-houses, barracks, and abandoned citadels. These are tlie liahifations of rliance. In this case it must be remembered that aeration, clean- ing, and, above all, disinfection are necessaiT to render Tlieni temporarily habital)le, for they are usually ver}' unclean and always open to suspicion. When necessary to construct temporary quarters, it is best to conform to the method of the country. Paillottes, huts of bamboq or of the leaves of the palm or ranevala, are of great service if the precaution is taken to erect them upon soil which has been cleared, rammed, and dried l)y fire. Care should be taken to make the buildings large, to have the walls and roofs thick enough, and to make the latter project all around the walls so as to form galleries. From time to time there is occasion to renew all except the framework, at least the straw and other 32 II !/(jieiie of the ^ohlicr m Hie Tropics. vegetable inat<'i-ials of llie roofs and walls, wliicli bec-oine impregnated with liuniidity and exhalations, and form, for that reason, a rt^-ejitacle for miasma. Finally, in case of epidemic, the commandant shonld not hesitate a single instant to abandon th'^sc (jnarters, which have cost so little, and consign tlu^m t(» the flames, while he erects others upon different ground. Pisa and mud have sonu- advantages, but only for tem- porary structures, to b<^ used for a longer time than the simple pdilhiHcs, and which should therefore offer more resistance. What is to be thcmght of ready-made huts, in sections, for the colonies? There is no lack of models: the ])avilions of Moysart and Espitalier; the movable barracks of Kave- nez; the tent of Doeker, of Lefort, <^tc. In onr oitinion, solid and thick paiJIol/es aie better. In Euroi)e the hut nuiy be of service; in oui- clinnitc the heat is never toiiid in summer; the rains have nothing in common with those drenching downpours, the common showers of tro])ical countri(^s. In Avinter there is every fa- cility foi- warming IIk^ interioi- of the quarters and for ]tre- serving a Aery sui)portable temperature. Is it the same in the hot countries? Theie the sun disjoints Avails and roofs and warjis metal plates; the water of the torrential lains inliltiates tliroiigh llie joints and crevices, the liuniidity cor- i-odes (he t imbers and insects devoui- them. All these struct- ures beconu' heated to tlu^ ]>oint of being uninhabitable during the day, but beconu' cool during the niglil. hi a woi-d, the nnidel of the ideal hut for hot countries is yet to be found. While awaiting the realization of this hygituiic de- sideialum. il would be ]»ossible to snpi»ly expeditionary columns with light and easily assembled inetnllic rimnework in s<'clions. \\'itli sti-aw, leaves, and branches, the screens Iljjf/iciic of Ihc iSoldier in the Tropics. 33 could be rapidly prepared, aud their juxtaposition would permit the erection of the huts witli great facility of construction. When it is absolutely iniitossible to raise the Hoor of the huts sutticiently or to have high camp beds, the ground, after being dried, should be spread with a thick litter of straw or dried herbs. The waterproof, which should always form part of the cohmial eciuipment, could be used to envelop this improvised mattress. At any price, it is necessary to avoid not only contact with, but a too close proximity to. the paludal, humid, and contaminated ground, and the ideal, in temporary as well as in permanent (piarters, is to remove the occupant from it as far as possible. It has always been known that, other things being equal, the upper floors of a dwelling are tlie most healthy. The same observation, ap- ropos of paludism, has been made in the most fever-affected colonies, like (labon, where those (piartered on an ujiper floor have been completely protected from fever, while those on the ground floor were stricken without exception. The very important statement may then be made, with- out fear of being taxed with exaggeration, that the most elevated dwelling realizes for individuals, in a malarial country, the excellent conditions obtained by communities, in the same country, by a constant residence in the hills — the hvgienic benefit of altitudes. J 34 Iliigieuc of the Soldier in the Tropics. CHAPTER II. Alimentation. To preserve the soldier from telluric influences, to en- able him to resist the attacks of paludism and thermic auiemia, the greatest care must be taken of his alimentation, and he must be assured the necessary quantity of the princi- pal articles of diet. It is also averred that the bad (piality of food, whether solid or liquid, is the principal source of dis- orders of the digestive organs. In other words, if it may be said that the prevention of paludism depends principally on habitation and accessorily on alimentation, the proposition may be reversed in the case of the second of the endenuc af- fections of hot countries, and it may be said that if dysentery can be influenced in its origin and evolution by a defective abode, it remains, aboAe all, an aft'ection of alimentary origin. § I. K vtritire Value of fhe L'olidii. In hot countries, as everywhere else, the comi>oiients of the ration should be combined in such a way as to secure the maintenance and reparation of streng^th. If properly com- posed, it should contain about 25 grams of nitrogen and 350 grams of carbon; that is to say, sufficient nitrogmous aliments, a suitable projiortion of hydro cai-bons, and enough fat to ijepair the tissues and maintain the jilieiioniena of calorification. At all times the soldier works enough to see his oigaiiic budget suffer greater losses by reason (»t ]terspirati(»ii and climatic fatigue than those suffered in Europe. Thus he must receive in hot latitudes a reparative alimentation, rich in hydro-carbons, abundant, and of good quality and variety. Hygiene of (he iSuhlier in the T rojjiex. 35 There are also conditions demandinji' that tlie ration be greater in campaign than in time of peace. Doctor Gayet fixes it thus for the two cases: In peace 23 gr. of nitrogen; 370 gr. of carbon. In campaign 20 gr. of nitrogen; 380 gr. of carbon. In Tong-King in 1885, the ration of the European troops would have been insufficient if it had not been supplemented by good pay, which permitted the messes to buy poultry and vegetables. In fact, it contained scarcely 20 grams of ni- trogen and 320 grams of carbon. In Dahomey, these figures were somewhat greater, cor- responding to 22 grams of nitrogen and 347 grams of carbon. The Europeans received 400 grams of fresh meat, in lieu of 300 grams, as in Tong-King. In the Soudan, the ration of meat was 500 grams, which gave 24 grams of nitrogen and 342 grams of carbon. A special ration has been issued to the garrison of Diego-Suarez since 1889. It is well composed, being equiva- lent to 20 grams of nitrogen and '■\X{) grams of carbon; it is rich enough in nitrogenous aliments and contains a proper proportion of hydro-carburets, but includes only such fat as is indispensable. Doctor Reynaud considers it nearly the type to adopt for the hot countries. The composition of the ration in Madagascar, for the campaign of 1895, was based upon precedent, and established, it might be said, with great foresight; yet it contained only 100 grams of vegetables in place of 120, and 40 centiliters of wine in place of 60. r.y decision of the Minister of War, dated January 11, 1895, it was fixed as follows: RATION OF THE EUROPEANS. Bread 750 grams. Salt 20 ^' Sugar '^5 " Cofifee, green 24 " 3t) Ilyyieiw of [lie Soldier in the Tropics. Rice 40 <,naiiis. Beans 80 Vegetable S<»n]» 30 " |>Jaking lUO Rrani.< of Vepetahles.) Meat 500 '' Tallow 80 '' Tea 4 Wine 40 centiliters. Rum 4 The ration of wine was issiK^l wIkmi ](()ssibl(^; in the con- trary case, a suhstitnte was made of rum or of tea. or of sugar and coffee. It was estimated that this substitution would be necessary one day in two. The Algerian tirailleurs could receive a lation of sugar in lieu of rum and wine; in this case they received no licjuids. Other substitutions were ]trovided for urgent cases: ordinary bread could be replaced hy TOO grams of l)iscuit or 600 grams of war bread; fresh meat, by 250 grams of preserved meats. RATION OF THE .MALAGASY TIRAILLEURS. Bread 750 grams. Fresh Meat 400 Beans 00 Salt 24 Rum centiliters. The 75(1 grams of bic^ad could be rejilaccd by 750 grams of rice, and the 00 grams of beans by 00 grams of rice. The ration of the Houssa tiiailleuis was identical with the above, exct^jiting Ihat the lum was replace*] by 21 grams of sugai- and 10 grams of gi-een cotl'ee. The coolies received SOO grams of rice and 24 grams of salt. The geueral cniiiiiiaiidiug the exjicdit ioiiarv coi-])s could order ceitain subsi it ut ions accoiding to circumstances. II i/l/iciif (if Ihr ^S(lI(lif'|■ iji the Tropics. ' 37 It is but just to acknowledge that the nutritive value of the ration wani suffieient in Madagascar; if our soldiers had to sutt'er from lack of food, the fault was exclusively due to the difficulty of transportation. The English, Dutch, and Italians have always had ra- tions superior to ours: 2S grams of nitrogen and oOS grams of carbon, in the Soudan; '2{\ grams of nitrogen and 458 grams of carbon in Abyssinia. ^^'e may state that the ration of 800 grams of meat is insufficient, not only in campaign, but also in time of peace. In the tropics ''the soldier is always in campaign; if not against the enemy, at least against the climate." It is true that his food can often be improved by the mess or by the paT'^^'refer- enee to albuminoids of vegetable origin, and carbon will be borrowed from the hydro-carburets much more than from the fats. A formula of admirable a]iplication to the dietetics with which we are now occupied is that of Trousseau. The most digestible food is the one which furnishes the greatest (pian tity of re]»ai'atory elements and requires the least i)ossil»le work of the digestive forces. In recalling this formula we will say that the su}>plying of food of the one kind or tht^ other is not a matter of indifference. Not only must the nutritive value of the food )><■ considered, but also its more or less easv assinnlation. Hygiene of the Soldier in the Tropics. 39 The (iiiautity should be sutticieiit ; the quality should likewise leave nothing to be desired. It is also important to give great latitude to receiving boards, and they should most attentively superintend the preservation of the com- modities in the store-houses. Bread, in order to be eatable and to furnish a healthful and savory food, should be made of well-dried tlour, passed through the drying stove, and kept, not in barrels, but in perfectly soldered tin boxes furnished with braces of tough wood. If the tiour turn sour in spite of these precautions, the damaged parts should be separated; then, after having subjected the parts known to be good to the heat of an oven at a temperature of 100 to 110 degrees, they should again be placed in the boxes which have been carefully cleaned. The same recommendations apply to biscuit and war bread. The mediocre quality of the meat, especially the beef, obtained in the colonies, due to the failure of pasturage, to insufficient care on the part of the natives, to the fatigue of the animal, often transported to its destination by sea or brought from a very distant region, demands careful atten- tion on the part of the experts in order to eliminate animals with tuberculosis or scurvy, or those worn out or preyed upon by paludism. The slaughtering and bleeding of the animals must also be carefully supervised, as the flesh spoils much more (piickly and easily than in Europe. Dried vegetables, beans, lentils, and peas should not be punctured nor shriveled; their cooking ought to be pro- longed and preceded by a soaking for at Ifeast twelve hours. SaiKiines in oil and cheese are very nitrogenous and reparative foods, and are well suited, in certain cases, to contribute to the composition of a campaign ration. They are usually well preserved. 40 Jhiijinic i)f Ihc Suhlicr in flic Tn))i\c.s. Fivseived foods, also provided for the periods of opera- tions, when the ronvovs and posts cannot be revictualed with the intinitely preferabk- fresh food, are principally pre- serves of beef, nintton, salted provisions, and vegetable soup. The preparations proposed, and those which are employed daily, are innumerable. I'nder tile form of tablets, sausages of various kinds, and lozenges, they are able to render great service. In their last campaign against the Ashantees, in ISIKJ, the English used The iinironiachie ration, composed of mutton and vegetables seasoned with sauce, and the emergency ration, with a base of chocolate and soliditied bouillon. Like fresh provisions, the i)reserved foods are subject to altera- tions. It is necessary to inspect the boxes, which wari) in the store-houses, and to make sure of the solder, which ought to be ]»ure tin, without traces of lead. The salt foods, bacon and corned beef, have great dis- advantages: they tire tlu- stomach and excite the thirst. They ought to tigure only occasionally in the ration, to vary the mess, or, in case of necessity, at the rate of two or three issues a week, as a complement to an insufficient ration of fresh meat. <\»dflsh is an excellent food and very nitrogeneous. it is o]»en to the same objections as the salt meats, and should alwavs be dry. odorless, aud without trace of discoloration. The cooks slnuihl soak it in seveial waters before submitting it to along cooking in boiling water. There has lately been much t in store-houses cooled to below zero (Centigrade) could b(- ])reserved indefinitely, transported as a loose cargo in ordinary wagons, even in summer, and consumed several days after thawing — could, in a word, furnish, in time of peace as in time of war. an excellent supply, having all the (]ualities of fresh, muscular flesh. .Meats preserved by cold have a comi>osition analogous to that of the best meats and undergo no sensible change. The taste is little modified and attention is reciuired to dis- tinguish these meats from the fresh; they are even more nutritive, quite as digestible, and, what is an important fact contrary to popular belief, they do not jnitrefy at once after thawing. 42 Ifijfjieiie of (he Soldier in Ihc Tropics. The process of preseiviug by refrigeratiou cau be ap- plied to game and poultry, and especially to eggs, milk, fruits, and vegetables. In England, milk arrives from Can- ada, frozen in enormous blocks. Cannot the alimentation of troops in campaign in the colonies lind in the utilization of these methods of preservation, perfectly applicable to the store-houses of our colonial cities, precious resources for future expeditions? A word upon dyiiarnogenic or accelerative foods, which have to a high degree the property of exciting the muscular and nervous systems. They are calculated to keep in breath, for long hours, men given up to intense work. Heckel has manufactured condensed accelerative ra- tions, containing all the elements for the alimentation of a. fighting man and sufficing to give him a strength capable of long marches. These rations are composed of meat ])owder and Kola nuts. They are in the form of a bar of chocolate or of biscuits, and weigh 25 grams. Their price is 3 fr. 25 per kilogram. From trials made up to the present, it a])i)ears that these rations can be utilized at a given mo- ment ; but it is better to employ them only as companions to the ordinary rations, on account of the dislike and digestive troubles which result from their liabitual use. We have recommended the most attentivt- su]»ervision concerning the (juality of the components of the ration. These precautions are not less necessary with regard to all commodities, whether animal or vegetable, coming from purely local sources. At military posts, as on board ship, the doctor, or, in default of one, an officer, ought to use the utmost care in regard to the food — game, vegetables, fruit, and fish consumed by the tables. In tile colonies, there are ])oisonous fruits \vlii» li sliould be known. Nor should it be f(»rgotten that in li(»t count i-ies, Hjjtjieiie of the Soldier in the Tropics. 43 seA'eial gipecies of tish are to be rejected as capable of causing trouble, especially at certain seasons. A condition concerning' living which may appear acces- sory, yet is important in a hot country, is the variety and proper preparation of food. It is not what one eats, but what one digests and assimilates that nourishes and repairs. In countries where loss of a])petite is experienced the best stimulant to oppose to the inertia of the stomach will always be the skill of a good cook. Now, without going into too much refinement, a post commander should superintend the cuisine of the men and direct the inexperienced European cooks and, with even more reason, the native Vatels. He should satisfy himself, personally, in regard to the manner in which the food is prepared, and as to its cleanliness, cooking, and seasoning. He should remember the precautions to be taken with regard to salads, cucumbers, radishes, and other products usually consumed in a raw state. Orders should be given and strictly carried out that they should never appear upon the tables without having been thoroughly washed and stripped of the least traces of impurities which might conceal the germs of dysentery and typhoid. Even more than in France, it is desirable that the soldiers should have utensils in good condition and scrui)ulously clean. Finally, the meals should be regular and taken at the same hours in i)roportioned (piantities. Regular habits should not be unnecessarily changed. An excess of food may be attended by serious consequences, resulting in gastric embarrassments and slight fevers. § III. Liquid Aliments. Wine, brandy, tea, and coffee constitute, with water, the only beverages useful in the alimentation of troops. Wine is an excellent and hygienic drink, and we have seen that it forms part of the ration of the colonial soldier. 44 Hi/gienc of liic Soldier in llw Trojiirs. Tlu' troops in France do n<»t receive wine in time of peace; the heavy war ration ]>rovin. Wine, containing alcohol, tannin, glycerine, sugar, vege- table acids, and salts of iron, soda, and lime, is at once ex- citant and tonic. It quenches thirst very well, especially when mixed with water, and sustains and revives the strength on occasion. For all these reasons we are of the opinion that it has its marked ])lace in the ration of the colonial soldier. The wine should be of excellent (piality with no alcohol added. It should not be "doctored" n per cent of alcohol, as that (juantity is indispensable to ])reserve it in a hot country. Unfortunately, these conditions are very difficult to exact rigidly from the dealers, on account of the purchase price. The wine may be very accei)table, at least to the taste, when it i& received by the colonial boards; but it deteriorates ra]>idly under the heat; it sours in the casks. It has been suggested to have it delivered in bottles packed in boxes; the trial has succeeded in the Soudan; but it can be a (piestiou of small quantities only, to supi>ly the weak etieclives. I'asteuri/.ation by cold, by the Chamberland filter system, might be of service if it were more practical and less burdenscmie. When the resources permit, on days of march or fatigue, there is no harm in doubling the wine ration at one of the meals, as is the custom al><»ai(l sliij). Tartisans of wine, we are not at all so of rum or brandy, Hi/giene of the Soldier in the Tropics. 45 whether ashore or at sea. This is a beverage to be reserved for the siek and for those suffering from cold or wet. Even then it should only be given mixed with an infusion of tea or coffee. Of these last, on the contrary, the (inantities issued should be very large, for there can be n<» bounty more profit- able to the man than the greatest possible allowance of tea, coffee, and sugar. AVhen the wine gives out. it is still with this form of alcoholized infusions, and not with i»ure alcohol, that the ordinary beverage should be replaced. To do otherwise is to seem to point out to the soldiers the necessity of jture brandy in the alimentation of che hard- working man, which is both contrary to hygiene and an encouragement to alcoholism. In our time, the tendency to consume alcohol of all qualities and at every opportunity is, unfortunately, only too extended, and the best means of preventing its abuse later would be to prove to the men that the use of pure alcohol is in no sense necessary to the health and that it may be dangerous. An evident fact, and one which we have brought to light in the statement of the causes of the diseases of the soldiers in hot countries, is the indisputable influence of alcoholic habits, chietiy the use of rum. in the production of ha^maturic bilious fever, hepatitis, and sun-stroke, and in the aggravation of enterocolitis. § IV. PotahJc Water. It is a current custom among the soldiers to charge to the account of the drinking-waters consumed in this or that colony almost all the affections contracted beyond the seas. The natives in man_A- places agree with them in this. In Upper Tong-King, the Annamites formally accuse certain waters of causing a swelling of the spleen when drunk in the crude state. Now, with tin- exception of fevers and ]»aludism, the 46 Hygiene of the Suhlier in the Tropics. genus of which, from all evidence, are taken up in the air b,y the respiratory organs, it is certain that the popular belief is well founded. A comniauder who can provide his men with an abso- lutely potable water may be almost sure, in all circum- stances, of {)reserving them from dysentery, hepatitis, ty- phoid fever, and cholera, and of protecting them against the less grave affections of which the eggs of ttenia and ascaris, the germs of fllaria, the fillets of blood-suckers, etc., are the most frequent causes. When one has seen the ravages occasioned by diseases of hydric origin, he is convinced that in peace, as in war, and even more in the colonies than in France, the (luestion of water is capital. To the same degree as the active prophy- laxis of malaria, it forms a stratum of the foundation upon which good and true military hygiene must rest. Always, in all circumstances, a commandant should ascertain if the water is potable and have means at his disi>osal to render it pure or to improve it. CHARACTERISTICS OF POTABLE WATER. A potable water is a water which is pure from both a l»hysico-chemical and bacteriological point of view. These two conditions are absolutely indispensable. Physically and chemically, a pure water is fresh, clear, odorless, and tasteless, ^>getables cook well in it and soap lathers. \\\ this standard, Ihe type of ]>otable water is that from a I iinning sjtring; then comes rain-water caught directly at the time of its fall in a drinking-glass; the watcM- of clear rivers, collected from the miure may result fiom infiltrations from the neighboring soil or from germs ditfused in the atmosphere, whether under usual conditions or in time of epidemics. A bacteriological examination alone can detect the presence of these pathogenic micro organisms; but with- out having recourse to a microscopic analysis, the impurity of any water whatever can be discovered and the presence of suspected organic matters revealed if they are sufficiently dangerous to necessitate the rejection of the water. This result is obtained by one of the following methods: 1. A very concentrated solution of tannin (reagent of Hager) is prepared; 20 grams of this solution is added to a 48 JJ i/ijiciui of ilte l^ohlier in the Tropics. large glass of water and allowed to stand. If tbe water becomes tnibid in less tlian an honr. it ninst be rejected. 2. Pour into a glass of water two or tbree drops of a 1:1000 solution of permanganate of potasb. If tbe solution becomes discolored — tbat is to say, los(^s its beautiful roseate tint, tbe water is not potable. A furtber examination is necessary, if it is desirt^l to be entirely informed and to seek tbe nature of tbe organic elements, suspected or otberwise. contained in tbe water, or tbe presence of tbis or that microbe. It is tberefore easy to ascertain tbe (luality of any water under any circumstances in wiiicb one may be ]»laced. and to know-, in a word, wbetber or not a water is potable. MEANS OF PURIFICATION. It sometimes bappens, es]>ecially in tbe colonies, and princijtally in cami)aign, tbat tbe commanding officer will liave neitber tbe time nor the means to have tbe water an- alyzed; he will then have doubts about its quality, from ignorance of its source or from other unknown conditions as to its origin. Sometimes, tbe circumstances in which be is l)laced, as in an epidemic ov in defective sanitary conditions. imi)ose increased ])i-ecautions. Finally, it may be tbat tln^ troo]is have at tbeii- disjtosal only a water which is mani- festly not ]»otable. as the watei- of a ])ond or of an unclean oi- badly situated cisteiii. In all these cases the absolute puiification of the liipiid given to the troops, for all alimentary uses, becomes a necessity of tbe first ordei-. How tan tbis imj»ortant ]»r(tblem be ]»racti< ally solved? There are a gi-eat man\ ways of ]>urifyiug watei-, we will l>oint them out briefly. f>tee])ing in alum has l»een einitloyed in tlu^ exti-eme Oiieiit fi-oin time iniiiicHiorial. It is of service in cduntries lii/(/i('iie of tlie SuhJicr in Ihe Tropics. 49 where the wateis aie veiv eaithy; but, in (nder that this process may be effective, it is necessary that the df'pot where the alum is made should have time to produce it. Now, as M. Laveran observes, the soldier needs a rapid process for purifying- water. Steeping in alum destroj's or precipitates only a part of the germs in suspension. The other processes heretofore employed have given only incomplete results. These processes, but little used in campaign, are: sterilization by heat; distillation, which re- quires special preparations, cumbersome and costly; boiling, which the army doctors have recommended for the past hundred years, while admitting the inconvenience and dif- ficulty of execution. The same objections apply to fllration with filters of all kinds, however improved they may be, heretofore utilized. They are costly, fragile, and unmanageable. Charcoal and amianthus filters (Maignen, Braver) clar- ify the water, but permit the passage of pathogenic germs. The Chamberland filter, called the Campaign, is heavy, difficult to transport with the column in a hot country, and subject to deteriorations which rapidly render it un- serviceable. Trials made during the Dahomey and Madagascar expeditions show that this filter is useful only in garrison. Besides, neither the Chamberland nor Berkefeld filter can be used by isolated men. The traveling filter (Chamber- land system), which can be taken apart and is contained in a tin box, and is composed of one or more hougirs joined in a collector, is too delicate and complicated for the soldier. At most it might be suitable for officers and explorers supplied with spare bougies. In Dahomey, several filters of various models were placed at the disposal of the senior commanding officer; 50 lli/(jieue of the Soldier in the Tropics. iiuiong them weie the Chambeiland and Maignen, a system consisting of a sort of funnel furnished with a felt dia- phragm. It was very quickly seen that the Chamberland filters, while useful in a hospital, a stationary ambulance, or a detached post, were unpractical for troops in campaign; the bougies became foul and the best of cleaning did not re- store the filters to their primitive condition. The officers gave the preference to the individual filters, the canteen filters, or the squad filters of charcoal and amianthus. There are several practical points in favor of the Maignen filter. If there should chance to be a deterioration of the apparatus, warning is inmiediately given by the black color of the liquid and the damage can be repaired. It is also easy to manu- facture all the parts of a similar apparatus, if there is a reserve of amianthus and charcoal. At the time of the Madagascar campaign, it was not known what filter to recommend, and none was adopted. The ministerial instructions prescribed the clarification of turbid water by the use of alum, by straining it through a cloth, and by boiling. The daily ration of tea was designed to insure the latter efl:ect. For boiling the water special pots were provided; it was never to be boiled in the pots used for making soup, as the water then contracts a taste of burnt meat, w^hich prevents the men from drinking it. These measures, the use of alum, straining, and boiling, wei'C often neglected, because it takes a great deal of time to make boiled water cool. Distillatory apparatus impose a great expense for pur- chase and setting up; their managenuMit retjuii-es expe- rienced men, and their uiainleiiance is costly. They can be employed only at the base of operations, and should be installed at the beginning of the cami»aign, before the arri- val of the tro(q>s. Hygiene of ilie Soldier in the Tropics. 51 Admiral Bienaim^ made an excellent use of a distilla- tory apparatus which had existed for a long time at Tama- tave; he caused it to be set up at Majunga, in 1895, and the soldiers of the expeditionary corps benefited by it. PERMANGANATE REDUCING-FII^TER. Impressed for a long time with the inconveniences in- herent in the different methods proposed and used in turn for the purification of drinking-water for troops in campaign in the colonies, our colleague, M. Lapeyr^re, principal phar- macist, has undertaken a series of laboratory studies which have led to a most happy result. Taking for his calculations the essays of Burlureaux, Girard, Bordas, Babes, Langlois, Girardin, etc., upon the use of powders with a base of permanganate, he succeeded in deducing from their combinations a process which we must particularly describe. Principle. — This process may be considered as the syn- thesis of two methods of purification — sterilization and filtration. The rapid and complete sterilization of water with a special powder, described below, has been demonstrated by experiments made at Kochefort, in the bacteriological lab- oratory, and at Paris, by MM. Laveran and Hanriot, of the Academy of Medicine. This powder is thus composed: Quicklime* gr. 05 ('rystallized alum, dry '' 12 Soda carbonate, dry '' 10 Permanganate of potash. . . . /• " 08 Total , gr. ^0 *('hitii.r v'lvc delitee. 62 Hygiene of the Soldier in the Tropics. These 30 centigrams represent the average dose to the liter, which may be given by a little measure of the same capacity. Alum enters into the composition of the sterilizing powder, as it is necessary to clarify the water of rivers. This acid salt forcibly combines with the carbonate of soda and a small quantity of lime, alkaline substances, which, in the jiresence of water, enter into chemical action with the double sulphate of alumina and of potash. The filtration, the object of which is to remove with the earthy excess in suspension in the water the excess of reagent, is accomplished by means of a reduciug-fllter of the greatest simplicity, based upon the proi)erty possessed by woolen texture impregnated with oxide of manganese, to reduce the permanganate of the reagent in excess in the water to be purified. Mode of Operation. — By the aid of a little measure, the sterilizing powder is thrown into a carafe of water about five-sixths full. The liquid, which has become rose-violet, is shaken, and if at the end of five minutes the color persists, it only remains to filter the water by aid of the reducing-filter. If the rose color of the liquid disajipears, a second measure of the sterilizing powder is added; and this process is continued until the rose jxMsists. ^yhen iJiis persistence of the ro^e Is ohiitined. it is an assurance lltal the water is sterilized. Then it is filleicd. The filtering nicdiuui is very simjdy (•(Mnjiosed of fiannel with a long nap, im]iregnated with sesquioxide of manganese, and then rolled \\\) like a cigar and encased in a box of small dimensions. This metallic box is of alum i num. fi-oni (I to 7 centimeters long by IS milli- nieteis in dianieter. It is cqien at one end and closed ;il tliC' Hygiene of Uie Soldier in the Tropics. 53 other by a metal ring, through Nvhich runs a short pipe, to which is fitted a rubber tube to act as a siphou. In the colonies the rubber tube would be replaced by one of impermeable fabric. The woolen flannel of the Pyrenees gives good results. It is made reductive by alternate saturations and cleansings of permanganate of potash. The thickness of the filtering mass is represented in this filter by the length of the box used, and the reducing power by the degree of purity of the wool and the proportion of oxide which it retains. As to the rapidity of the filtration, it naturally depends upon the degree of permeability of the texture and also upon the length of the rubber tube. For the individual filter, the rapidity is sufficient to obtain a liter in fifteen minutes on an average. In order to filter the water which has been sterilized, as indicated by the per- sistence of the rose color after the addition of the sterilizing powder, the filter is plunged in it and the siphon primed by aspiration. It only remains to collect the water in a glass, a measure, or a carafe. The water which flows from the tube, clear and limpid, is absolutely potable. To clean the filter there is the same simplicity of process. It is sufficient to withdraw the flannel from the box and to wash it, rubbing it betw een the hands, after having dipped it into pure water or water to which the sterilizing powder has been added. It is then rolled up again like a cigar and replaced in its receptacle. Scientific Value. — This system has been submitted to the ''Conseil superieur de santt' de la Marine," which has ac- cepted it in principle. The Academy of Medicine also took up the question and appointed a commission, which made a favorable report. MM. Laveran and Hahriot are satisfied that the patho- 54 I] ijgiene of Ihe Soldirr in the Tropics. genie microbes which most often contaminate water (bacil- lus of typhoid and spirillum of cholera) are destroyed in water purified by this process. Certain sporular microbes resist, but they are always non-pathogenic. On the whole, sterilization by this simple and really practical process is sufficient. Some criticisms of detail have been made regarding the composition of the powder, which, however, has been modified. It might be feared that the powder would be altered by the air, or would obstruct the pores of the filter by the pre- cipitates, and thus rapidly diminish the delivery. Nothing is easier than to i)rotect the powder from the air by a well- closed box. The fouling of the woolen flannel is not to be feared. It is easily cleaned and its daily washing ought to be an obliga- tion. Has it not been said, with reason, that the best filters are those which became fouled most easily, because this is the proof that they play their part perfectly, and therefore im])0se the duty of cleaning them often? The action of the sterilizing powder upon metals is not to be feared. It does not attack inoxidizable metals, and the deposit of oxide of manganese which may form upon these metals is absolutely inoffensive and can be easily removed by washing. With ]\I. Laveran, it may be said that the Lapeyr^re system marks a real ])rogress in the imjiortant question of the purification of water. Application to Troops in Catnpaitjii. — The individual oi- pocket filter, such as has just been described. i)ossesses the following desirable qualities; absolute decoloration of the l>ermanganate of ])otash, rajiidity of filtration, limi)idity of the filtered li(|iiid, lightness, solidity, and ease (»f iiKUii]Mila- tion and cleansing. ]] il'jicnc of tlic Soldier in lltr Trnpir.'^. 55 It was a question of making' it practical for the soldier in cani]>aign, and M. Lapeyr^re thinks he has succeeded. The soldier's filter differs from the ])ocket filter only in its greater length. It can be put into the canteen of the regulation model, whence its name — ''hidon-fiJfreJ^ It is fixed either permanently or temporarily to the cork of the large opening of the canteen by a metal aspirator tube. This tube passes through the cork and extends several centimeters outside. The canteen also has an inoxidizable metal flagon fixed on one of its faces, with a capacity of about 35 cubic cen- timeters, containing the permanganate powder; a little measure is hooked on the interior of the hermetically sealed cover of the flagon. In case of a beverage which requires neither sterilization nor filtration, the filter remains closed and the soldier drinks from the ordinary opening of the canteen. If it is necessary to filter the water, the soldier fills his canteen, pours in a measure of the permanganate powder, puts the filter in place and shakes the canteen violently. He can drink directly from the canteen, or, after putting on the aspirating tube and placing the canteen upon an elevated place, his knapsack for example, he can start the flow of water by aspiration and receive the sterilized and filtered water in his quart cup. After the canteen has been used about ten times, the filtering medium should be withdrawn and cleaned. This can be done while resting during the halts; the canteen itself should be i)urged of all deposit and washed with water con- taining one or two measures of powder, to destroy the organic matter which might adhere to the walls. AI. Lapeyrere has busied himself with remedying certain material imperfections pointed out in the report of the 56 Hygiene of the Soldier in the Tropics. Academic Commission. It will be possible, for example, to tind a way to protect the powder from the rain and to pre- vent the box from forming a troublesome projection. It is easy to keep the apparatus in repair; it must be acknowl- edged, however, that the purification of the water intended for drinking will be best assured if it is made for a group of men, as a s(iuad or a company. If it is left to individual initiative, without supervision, it will yield the least desir- able results; it is the sanie with the most elementary hy- gienic prescriptions. As surely as the methodical use of an efficacious process is prescribed by authority, cases will be seen where, escaping all sui>ervision, the soldier will con- sume non-puritted water. The great merit of the reducing filter is its extreme sim- plicity. It is at ^everybody's door; it can be purchased or constructed at little expense ; it can be operated and cleaned with the greatest ease. The necessary materials to make one can be found every- where and always. There is not a colony whose market can- not furnish the sterilizing powder and prejtared woolen flannel, or at least fine and well-cleaned sponges. The most simple filters have always been the best. The troops in Abyssinia were recommended to take a small linen cloth, make a sack of it, fill it with powdered charcoal, join to it a tube ]»lunged to the middle of the filtering substance, di]» the sack in the water 1(» be filtered, and suck the water through the tube. The system we ha\e just studied is more scientitic. but (piite as simple. We believe it is destined to render great service to the colonial troojis, in the gairisou towns, and, above all, during expeditions. rp to the present, fillialion alone lias uol been able to act u]M»n the soluble luorbid organic agculs. sucli as lln' Hygiene of the Soldier in the Tropics. 57 toxiiies and the alkaloids. The permanganate of potash connected with filtration has a very great advantage in improving water for drinking. Alimentary hygiene is easier to observe than the hy- giene of habitation. Individual initiative is here all power- ful, and it can not be too much developed by teaching each one what he ought to do to avoid the diseases whose germs are absorbed bv the digestive organs. 68 Hygiene of the Soldier in the Tropics. CHAPTER III. Clothing and Equipment. "Not to get cold is to avoid almost certainly all the causes of disease." These words of General Wolseley ought to be inscribed in the rooms of our colonial barracks in the same manner as the English inscribe upon their wharves in India: ''Beware of the Sun.'' Indeed, if certain parts of the apparel, like the helmet, are intended to prevent sunstroke; if the shoes ought to as- sure the protection of the feet and the lower limbs against insects and the asperities of the soil, the principal role of the clothing is to prevent the loss of the heat accumulated by the body within. It is precisely because one is warm and is often in a perspiration in the colonies that one needs to be covered; without overloading the body with too heavy and thick materials, it is necessary to cover it to avoid the currents of air. A too rajiid evaporation of the perspira- tion from the surface of the body chills it; there is the danger. A man who is cold is on the verge of disease; he is more susceptible to simple diarrho-a, to dysentery, to hepa- titis, to an access of fever, and to physical disorders gener- ally. They declare themselves in him as soon as a sufficient cause shows itself; if they already exist in a latent state, their evolution is inunediately accentuated. The clothing of the soldier in the colonies has been the object of wise modilications; it might be improved still more and be more specialized in certain circumstances. Notwith- standing the imi)rovements made, the last word has not been said. Ilj/niene of the Soldier in lire Tropics. 59 § I. KuJes of the Hygiene of Clothing. The principal rules of the hygiene of clothing for the colonies may be stated as follows: Wear warmer clothing in the evening and at night than in the day; always wear a flannel band at night; wear a helmet or equivalent head-covering from morning to even- ing; have extra shoes to wear after the march; use an equip- ment which neither overloads nor compresses any part of the body. It is not long since soldiers in the far East were clothed almost the same as in Europe. Before 1800, the colonial troops were furnished with no light clothing except white trousers. During the campaigns in China and in Mexico, the troops made use of a cap covered with white linen and with a havelock of the same material. Later, in Cochin-China, they adopted the straw hat and the native salal-o. Shortly afterwards a trial was made, for the garrisons of Senegal and Cochin-China only, of a paletot of special flannel, for ordinary wear. In 1873, the large flannel belt was given to all the soldiers in the colonies. It was not until 1878 that really important measures were adopted. The different head-coverings were replaced by the cork helmet covered with white linen; the cap was kept only for morning and evening wear, night guard-duty, and traveling. The flannel jacket was made regulation for all our possessions. Flannel trousers were tried and subse- quently adopted. The large red belt was replaced by a small white one worn directly over the flannel vest. In 1883, the flannel dolman was adopted for the use of officers and adjutants. It was the day dress for drills and campaign, the dolman of France being always reserved for full dress. 60 Hygiene of the Soldier in llie Tropics. By a decision, in 1886, every man in the colonies received for wear during tlie daytime a paletot of linen or cotton twill of a brown color. With the helmet, the trousers, the gaiters of cloth, and the flannel belt, was at last realized the practical clothing long since adopted by the other European nations for their colonial soldiers. The officers also received, as a day uniform, the white linen jacket, to be replaced on occasion by the blue flannel dolman. Thus it took more than twenty years to accomplish this ■ great reform in hygienic clothing, which an ill advised economy had postponed, to the great detriment of the health of our troops. For the campaign in Madagascar, garments of flannel and of brown linen were adopted, the flrst for evening and the second for day wear. In the evening it is absolutely necessary to replace tlie linen by a warmer material, espe- cially, in the case of the garments which i)rotect the stomach. Every country may require some modifications in the clothing. In a hot country, the object of clothing, at least during the day, is to protect the body from the solar heat, while permitting its own heat to be emitted. Now, after Coulier, cotton and linen have a much greater emissive power than wool; but they absorb humidity rapidly, and the body they cover cools rapidly if it is in a perspiration. As to colors, white absorbs heat the least, black having the maximum absorbing power. At night, absorption is no longer to be feared, and it is necessaiy, on the contrary, to prevent a too rapid emission of the body's heat, favored by a diminution of temperature, somclinies considerable. It is therefore necessary to change the rlothing to that which will give more pi'otcction thiin ni/f/ipiie of the Soldier in {he Tropics. 61 linen and cotton and which will absorb humidity well and become cool slowly, such as light-weight woolens or fianucl. § 11. The Different Articles of Clothing. From what we have just seen, clothing of white linen and white cotton will give the best results. If the white color is too easily soiled or too visible to warrant its being chosen, the choice should fall neither upon black, blue, nor even red, but should be limited to the light tints bordering upon yellow or light brown. A brown color which gets lighter when washed would seem to fulfill the conditions reasonably well. Besides, as a simple material of cotton or linen applied directly upon the tissues would cause a too rai)id cooling of the body, there should be at least two layers superimposed; the first, applied directlj^ to the skin (waist- coat, cotton drawers, shirt); the second, forming the outside clothing (paletot and trousers of linen or cotton). These two envelopes, having between them a layer of air, which is a bad conductor of heat, diminish absorption on the one hand, and a too rapid elimination of heat on the other. The adoption of the brown linen clothing was rational, it is excellent for the hot hours of the day; it is less visible than white and is not so easily soiled. The brown linen clothing now issued to the French troops is lighter than that of the English, but the color will not resist more than two or three washings. The superiority of the English color is due to the combined use of areca nuts or of walnut husks and a salt ofjron, which enables it to resist the decolorizing action of the sun and also of water, alcohol, weak acids, alkalis, and hyi)Ochlorites. In France the coloring is done wdth brown analine, curcuma, i-oucou, logwood, etc., whence the slight resistance of these colors and their incontestible inferiority. There is a defect in the brown jacket. It is cut much too low, leaving the neck uncovered. If it is important not 62 Hygiene of the Soldier in the Tropics. to compress the region of the neck, it is necessary to protect it against the sun's rays; a collar capable of being turned up and down at will might be adopted. As underclothing, every man ought to have two shirts of cotton flannel, less irritating than the flannel waistcoats; two pairs of drawers, a belt of wool, similar to that of the Zouaves, and a belt of flannel; also, two handkerchiefs, two napkins, and a neckerchief. The flannel pea-jacket, while natty for review, is too heavy and warm to be worn during the day, under any cir- cumstances. Except in Tong-King in winter, it ought to be for night wear; but then it is indispensable. The trousers are subject to the same remarks as the clothing for the trunk so far as the nature, color, and flexi- bility of texture are concerned. The necessity of replacing the linen, in the evening, by a material aft'ording more pro- tection and warmth, is still more imperious with regard to the trousers, by reason of the great sensibility of the abdom- inal organs and of the extreme frequence of the affections which concern them. It is necessary then to provide linen trousers for the day and flannel ones for the night. The outside clothing, com]»rising the great-coiit and cloak, should be provided. Useless in the hot countries, except in Tong-King in winter, they should be deposited, on the debarkation of the troops, in the store-houses at head- (juarters, to be obtained again at the time of returning to France. They will then be indispensable, at least at the end of the voyage, as will also be cloth trousers. On ex])editions, the imiiermcable covciing with which the Americans have long jjrovidcd their soldiei-s would be of more service than a cloak. If the rain stu'iniscs the colunin (III the march. Ilic men unroll the c(»v('i' over the head and arms, luiiiiug tlic i-iibbci' side out. This inipi-ovised garment Hygiene of the Soldier in the Tropics. 63 falling behind and slightly before, without ever masking the view, would leave the sides free for evaporation and at the same time prevent the men from getting wet. For officers, the clothing should comprise: a pea-jacket of English tlannel (blue or red), with a very low standing collar; a brown linen vest, one pair of trousers of blue flannel with stripes in piping, according to arm; and one pair of trousers of brown linen. The best head-covering is the one which unites to sta- bility the protection of the back of the neck and the eyes. The only head-gear admissible in the daytime is the colonial helmet, which permits the air to circulate freely around the head and to escape through the openings; the visor is lined with leather or cloth of a green color to soften the effect of reverberation. Formerly the colonial helmet was subject to some criti- cisms of detail; it was too heavy; it is now much less so, and can be lightened still more. It was too narrow at the sides, and what it gained in elegance it lost in failing to protect sufficiently the sides of the head; it has been enlarged with- out damage to the shooting capacity of the wearer. In campaign, with a view to obviating the too great visibility of the helmets, it is well to put on a cover with flowing ends, which increases at the same time the protec- tion of the temples and of the nape of the neck; the best material is still the brown linen. While furnishing pro- tection from the direct action of the sun's rays, it protects at the same time from reflection, which is the cause of numerous febrile attacks, for fever is often tal-en through the eyes. With the object of giving more effective protection to the organs of vision, the wearing of spectacles of smoked glass should be authorized on the march and on guard. The English in Egy})t have used them. With the same end, the river boats 64 Hygiene of the Soldier in the Tropics. used for the transport of the personnel should have double tents with curtains of blue bolting-cloth. Every man found without his helmet between the rising and the setting of the sun ought to be considered guilty of disobedience of orders and severely punished. It is a neces- sity to prevent the soldiers from exposing themselves to the sun as well as to the nocturnal cooling. The cap has its raison d'etre only as a night head-cover- ing. It should only be used between sunset and sunrise. In anv place, the cap, which is a protection from neither heat nor rain and compresses the head, from which it keeps the air, ought not to be worn during the day. During the Madagascar campaign the head-dress called bonnet de police was preferred to the cap — and seemed much more hygienic, because it protected the eyes and ears. The function of the shoe is to sustain the foot, to preserve it from sores, excoriations, and wounds which would result from marching barefoot, and to defend it from the incessant attack of innumerable enemies: serpents, fleas, chigres, scorpions, betes rouges, lice of the agouti, bloodsuckers, etc. It is evidently improper to give colonial troops light shoes of cloth, as they would have too little resistance for inarching; nor could one dream of making them imitate the natives, avIio march barefoot. The shoe must be both solid and flexible, and must be kept, in spite of the heat and humidity of the hot country, in such a condition that it can be easily put on and removed. In Madagascar, the ofticers wei-e ])rovided with boots or with brodekins with legs; the www had Xea])olitan brodekins for the maich and a ]»air of rsjtadritlr.^ for repose. That was an excellent innovation; it would be desirable to have the soles of the espadrilles made of thick leather and very i)roject- ing. The reform might have been made complete^ by giving Hygiene of the Suldicr in the 'Tropics. 65 light gaiters of sheep-leatlier, more coiivenieut to keep in good order thau the cloth legs. To keep the shoes of their African soldiers in a suitable condition of flexibility, the Italians recommend a mixture of fish-oil, turpentine, and grease. Before the march, the feet should be washed witb water slightly alcoholized; they should then be greased with soap, or, better still, with grease. In the absence of socks of cotton or linen, the foot should be enyeloped with a strip of the latter material. At the end of the march, the men should wash their feet, using warm water when possible; the heayy shoes should then be replaced by the light ones. A white umbrella lined with a material of green or blue is indispensable for all officers or agents obliged to "super- intend work in the hot hours of the day. With regard to equipment, it will suffice to say that in colonial expeditions, a man ought to carry on his person only his arms, ammunition, some food, small articles for change, and a waterproof. The soldier on the march in the Tropics, cannot carry a weight ayeraging 25 kilograms with- out great inconyenienee. Eyen admitting that all the equip- ment be of aluminum, as has been proposed, the weight would still be too heayy. This is one of the great difficulties of military expeditions in the hot countries, for it necessi- tates joining to the combatants a yeritable army of coolies to carry the equipment. Each soldier ought to have a coolie. The campaign in Madagascar was attended with sad results because this con- dition was neglected. The soldier on the march was obliged to carry his knapsack, as well as other articles of accoutre- ment and camp equipage. To impose so heayy a burden upon a European in the hot counti-ies is to condemn him to ineyitable sickness. 6Q Ilygieiw of iJie Soldier i)i the Tropics. § III. MalnlciKuice of Cloth iiuj. lu the chief places of the colonies and at posts easy of access, the troops receive it^^iilarly. as in France, the clothinfi- and linen allowed by the r(^};nlations. It is not so in the case of isolated posts. Difhciilt even in ordinary times, the supply of clothing to meet all de- mands then becomes a problem. In the Soudan, for example, after seven or eij;ht months of work, the men relieving the gan-isons of the posts arrived there with clothing in tatters and incapable of the function assigned it by hygienic principles. The means of remedying this situation, so defective and prejudicial to health, would be to have in the storehouses of these posts a sufiticient quantity of clothing to i»roperly supply the men, instead of compelling them to remain for mon-ths with nothing to cover them but unifomis in rags or other unsuitable clothing. The washing of the linen is important. In the cities it can be done by contract, ajid a laundn- would be an ad- vantage at every post. The men would tluni be able to take care of their linen without exposing tliemselves, either on the river banks or under unhygienic sheltei-s, to the emana- tions from the shore or to the action of solar reverberation. They would also be freed from the services of the exotic washerwomen, who tear tlu* linen and oft(Mi return it only half clean. In taking care of the clothing, the linen, and the vari- ous articles of e(iuipment, the (piestion of cleanliness is con- nected with another, of evtm greater imitortance, which should b<' understood, not only l)y the doctors, but also by the officers; this is the (|ues(ion of disinft'ction, esj>ecially the disinfection of articles in use. The disinfection of clothiii'; and bedding is a measure \^^ ' Of , Hygiene of the Soldier in the Tropics. 67 which should Ix^ taken in all colonial garrisons in case of death and also in conta5j;ious diseases, after the soldiers are cured. This would prevent many cases of disease and death from the reviviscence of the morbid germs contained in the effects. In large centers, provided with improved appliances, the clothing and bedding are placed in a drying stove, receiving vapor, under pressure, at 110 to 115 degrees. ^^'here these large apparatus are not available, a solu- tion of bichloride of mercury of 1:1000 can be used, in which the clothing and bedding are dipped; they are then placed in boiling water, except such articles as would be injured. Clothing is often the means of propagating epidemic diseases, and articles of clothing which have been worn should never be issued without first subjecting tliem to effective disinfection. 68 Hygiene of the Soldier in the Tropics. CHAPTER IV. Military Life. No one is iguorant that iu the Tropics the days aud nights are of practically equal length. The first hours of the day are undoubtedly the most healthful, and if it is not a good thing, especially in a paludal countn-. to get up be- fore sunrise, it is not bad to rise with the sun. From six to ten o'clock in the morning is the first working period of colonial life; the second extends from three to seven in the afternoon. One does not go out at all from noon to four o'clock, and during this time afi'airs are practically sus- pended. There is a reason for these habits in the colonies. It is dangerous to be exposed to the sun at the zenith, and the European soldier, more sensitive than the native, should be warned against the dangers he may be made to run by a hygienic error. The military authority, always vigilant, will be able to protect him by establishing a list of service, which alternates work and rest and takes into account the exigen- cies of climate. § I. Occupations of the Soldier. In the colonics, drills are necessary to occupy the men, to prevent them from losing the ]»rofit of tJie military in- struction received in France, and to prepare Ihcm for the eventualities <»f an cx])edition; they are also beneficial to health and are a pi'ccious antidote to ennui. They should invariably fulfill a double condition: 1. Take place at selected hours. 2. l>e of short duration. The hour naturally indicated is (he nioruiiig hour fol lowiug lising. It is usually prcl'ci ird, as Ix-ing the most llygiene of the Soldier in the Tropics. 69 agreeable and the one in which the man is in best condition and best capable of effort. With reveille, about five o'clock, according to place and season, the man goes to drill, either every day, or two or three times a week, from six to seven o'clock. The drill lasts from one to two hours. The men should never be sent to drill, however, on mornings when there is a thick fog. Experience and observation show that such fogs, rising with the sun, are the surest vehicles of the parasite of malaria. An imprudence would also be committed by ever sending the men to drill on an empty stomach; the first breakfast should precede the drill, as an empty stomach predisposes the system to the pernicious influence of emanations from the ground. Under these conditions, in all the colonies, the soldier can be exercised for at least an hour in the manual of arms and in various movements, with rests of five minutes at the end of each half-hour. When the men are well trained, it will be advisable to reduce the length of the drills, which are more enervating in the hot countries than in Europe, when they are prolonged or too often repeated. Marches should be of short duration. As it is necessary to prepare the men, even by a little training, for a mobiliza- tion, which might take place at any time, it would be well to nuike them execute, once a week in the good season, and from six to nine o'clock in the morning, a march of fifteen kilometers, during which care should be taken to observe all the precautions taken in time of war. V\e will take occasion to refer to this matter again in the chapter on expeditions. It is evident that longer marches will be required in actual service and that there will not always be latitude to halt ten minutes every hour; but under pretext of training. 70 Hygiene of (he Soldier in the Tropics. exhausting effort should never be uselessly exacted. A company accustomed to make a march of fifteen kilometers frequently, and without inconvenience, can make double the distance on occasion, under the influence of a moral stimu- lant, especially if it is vigorously commanded. The colonial, like the metropolitan soldier, will do his duty when it is a question of getting at the enemy, of marching to the sound of cannon, of flying to the aid of a place or of his brothers in arms. Although in France it is permissible for a command- ing officer to test the resisting powers of his men by one or two practice marches, the fatigue of which will affect their health only slightly, it is not the same in the hot countries. Experience of what takes place on expeditions proves that an exercise of this nature may have disastrous consequences for a company. The reviews should also take place in the morning at the same hour prescribed for drill. Not being fatigued by a day of heat and occupations, the men will present a more cheer- ful and alert appearance. From ten o'clock in the morning to four in the evening. all outside drills should be prohibited. In this interval, gymnastics may be tolerated. A light costume should be worn, there should be a sufficiently long rest between movements, more diveisity and less monotony should be sought, and, above all, there should be great lati- tude concerning the number and difficulty of the <'xercises to be practiced. It is the same with fencing, whicli should be carried on indoors. In addition to jdiysical military exercises, the j)rofession of arms includes theoretical instruciion. This should be given iijioii the galleries instead of in the i-oonis. unless special places are available, such as dining rooms, school- rooms, etc. Hygiene of the Soldier in the Tropics. 71 The best houis will be from eight to ten in the morning and from two to four in the afternoon. Theoretical instruction should never be too much pro- longed under penalty of tiring the soldier, who ends by suc- cumbing to the heat, joined to the immobility, and loses all the benefit of the instruction. An hour's duration should suffice. The hours suitable for theoretical military instruction are also suitable for general instruction. There is no objection to devoting an hour a day, upon an average, to lessons in reading, writing, and arithmetic. For men more advanced, the instruction in the barracks can and should be extended so as to become a regular course for adults. Above all, an attempt should be made to interest the soldier; that is to say, to teach him about all that surrounds him, to make him accpiainted with the colony in which he lives, its resources fuid its products. This elementary in- struction should be given by officers, assisted by non- commissioned officers, and the post surgeon could add with profit some lectures upon the special hygiene of the climate. This teaching should be in the nature of object lessons and adapted to those who receive it. Through them it will be spread and will give an exact knowledge of our possessions beyond the seas. The military service will then have the double advanitage of providing our colonial empire not only with defenders in the present, but also with arms for the future. The officers and non-commissioned officers on their part should often devote themselves to work, either to cheat ennui, or to instruct themselves, to prepare for examinations or for the military schools. Thej should know, however, that an excess of mental work is dangerous and that the 72 Hi/giene of the Soldier in the Tropics. expenditure of stiengith is quite as considerable as that pro- duced by physical work. The hours to choose are those of the morning, or at least of the forenoon, to the exclusion of the hottest portions of the day. As to night work, it ought to be absolutely interdicted, or at least should never en- croach on the hours which should be devoted to sleep. § II. Fatiyve Duty and Other Work. It will no longer be possible fto see sailors coaling their ship at the hour when the convicts are faking their siesta, as once came to pass in Guiana. There are fatigue duties which must be done by the soldier; but he ought to be exempt from certain kinds of work: in any case, soldiers ought not to be transformed into coolies. FATIGUE. There is a distinction to be established between the fatigue duties on the interior of the buildings and those outside. Interior Fatigue. — The soldier ought to be charg(^d with the care of his quarters, his bed, and his clothing; in all that concerns the sweeping, good order, cleanliness, and regular disinfection of the buildings, he will never be better served than by himself. Doctor Reynaud gives some excellent advice on this subject: "Immediately after tlie men rise, ojien the windows and the blinds of the gallery on (he sunny side, leave the beds uncovered for a few moments, pass slightly dam|iened cloths ovei' the floor, and let it dry immediately for sweeping; re- (|nii-e tlie men to biiisli and jiolish theii- ell'ecis on the gallery, then sweej) it and wash it witii a damp nio]>, oi- even Hood it with water if it is coveri'd with glazed tiles and has suflieient slope to insui-e drainage: once a week, wi|ie the panes of Hygiene of the Soldier in the Tropics. 73 doors and windows. The same day. it will be well to add to the water used to wet the cleaning-cloths a certain quantity of carbolized water, of say 50:1000, or a solution of bichloride of mercury. The dust collected in the interstices and corners should also be sterilized.'' The cleanliness of the rooms and of their materials includes also the care of the bedding. The sheets should be washed once a month at least, and the coverings aired and beaten on the galleries. Ordinary mattresses, unless those of cocoa hair or granulated cork are alone used, should be renovated and beaten once a year in ordinary times. It is also necessary to provide for the painting of the rooms, the coating of the feet of the beds with petroleum or carbolized tar, the beating and repairing of the mosquito bars, th:^ insufflations of chamomile powder, and the distribution of the cuspidors, disinfected with a sulphate of copper solution of 50 :1000 or with whitewash. There are also soldiers, designated by roster, who are charged with allowing no unclean thing to remain in the quarters. Through their care, the sweepings and the debris of the tables after each meal are collected and placed in the dirt-boxes; the utensils are cleaned, being washed in warm water every time they are used. Exterior Fatigue. — The policing of the annexes or of the yards of the barracks should never be done by whites, as much for hygienic reasons as to inspire respect for the uni- form on the part of the natives. Under the supervision of Europeans, there are coolies or laborers who can always per- form, in the English fashion, the service of cleaning the yards, prisons, store-houses, and, with more reason, the latrines and other sinks. After the moveable tinettes are taken outside and away from the barracks, it belongs to the coolies alone to flood them and wash them clean with disin- fecting solutions. 74 Hygiene of the Soldier in the Tropics. If certain intei-ior fatigue duties are harassing to the French soldier, what is to be said of the purely exterior fatigue? Here, it is necessary to go for water, every day, several kilometers from the barracks; there, the port of debarkation, which supplies the post, is separated from it by a long and tiresome route, over which must be drawn or car- ried boxes, packages, and casks, which sometimes have to be hoisted to quite a height at the military buildings. More- over, it is a laborious and often perilous task, which requires a large portion of the effective force, at dates often close together, either to go to a distant roadstead to disembark the provisions from a vessel, or to go there to bring back the material. The wood details to the neighboiing forests, the extraction of stone from a quarry, and the^ procuring of sand for the gardens, are always prejudicial to the health of Euro- peans. How many attacks of fever or of dysentery have had their origin in fatigue duty of this description! Thus, every garrison should always have native coolies, who, under the supervision of Europeans, are charged with all troublesome fatigue both on the interioi- and exterior of the military buildings. At the rate of one coolie to t(Mi men. all would go smoothly. The savings realized u])on days in the hospital and medicines from the infirmary would provide foi- their maintenance without •increase of expense for the regiment. ^loreover, in many of the colonies, the local administrations cmjiloy a certain number of ])risoners on road and gardening works. Why shouhl the military service not jH-ofit by this manual labor as well as tlu^ municipality? In the penitentiary (■oh)nies. without mixing the peii;il and military element, certain exterior woik could be done by the convicts. If foreign manual labor should fail, it would he necessary to ])rovide wagons, caits, horses, oxen, and mules to iicconijilisli the ciirlage and lians]ioit. Hygiene of the Soldier in the Tropics. 75 WORK. In addition to fatigue duties, there is other work about the barracks and military buildings, which must be consid- ered. For example, gardening, working at a trade, and works of excavation and defense. Gardening. — The maintenance of a garden plavs an im- portant part in the military life of a garrison, for on it largely depends the welfare of the company and the officers from an alimentary standpoint. The officers and soldiers are usually eager to give great care to the cultivation of the garden. The gardener sometimes lives in the garden, in a sort of hut of primitive construction. While there is no serious in- convenience in this in certain colonies, it would not be safe in a paludal country. The guardian of the garden at night should be a native. Digging, removing the earth, and other laborious work should likewise be performed by native coolies serving as permanent aids to the European gardener, whose active duty should be limited to direction and super- vision. The sowing, gathering of fruits, harvesting of vege- tables, and sprinkling might sometimes be done, without inconvenience, by Europeans selected from men undergoing punishment or from volunteers. They should work only morning and evening, never during the hours when ontside work is forbidden. WorHng at a Trade. — This kind of work, as performed by soldiers in the colonies, is of several kinds. There are first the sedentary trades, those of the tailor, shoemaker, hair-dresser, armorer, painter, which are not fatiguing and are carried on in a desultory way. It is often necessary to call upon the special talents of the men, who are generally satisfied to occupy their leisure in utilizing their knowledge. 76 Hygiene of the Soldier in the Tropics. Certain trades which are more fatiguing, as tliose of butcher, baker, aud cook, should only be practiced by Eu- ropean professionals. They should always be assisted by a sutficient number of native coolies to exempt their function from all laborious and humiliating work. In addition to these interior works, there are others which arise unexpectedly and which it is incumbent on the prolessionial military mechanics to perform: soldiers of engi- neers, pontoniers, and artillery mechanics. Sometimes there is an insufficient number of these professionals and they have to be assisted by soldiers taken as far as possible from those who were masons, carpenters, joiners, or slaters be- fore their entry into the service, for it is a question in this case of the construction or repair of military buildings. This work ought to be done during the hours chosen for outdoor drills— that is to say, in the morning or evening. In the hottest hours, about noon, work should be entirely sus- pended, even in the buildings or under the more or less impro- vised sheds. There, the time prescribed for exterior work might occasionally be extended an hour or two, morning and evening. In unhealthy countries, all work of this kind is most troublesome and dangerous, as it exposes Europeans to the sun and to febrific emanations.' In 1840, Th(^venot had already pointed out the excep- tional morbidity and moitalily among the artillerymen and mechanics, especially during cxj^editions and during the early periods of occupation of a ]><)st. He attributed this, with reason, to the special works on wliidi these soldiers were then employed. Obser^ ations of the same nature have since been nmde in tlie Soudan, Dahomey, and again, but recently, in Madagascar. A t Koutonou, in 1800, the mechan- ics '^f nrlillcry cuiiih^vrd in erecting barracks showed a iiioiliidity ol' (;i per cent, after a stay of tlii-cc niontlis. Hygiene of the Soldier in the Tropics. 77 Tlu'se workmen should be subjected to all the more care- ful supervision because many of them who are sick avoid presenting themselves to the medical officer in order not to be deprived of the high pay accorded them. This is an important consideration. If it were disregarded, and the small number of exemptions furnished by the workmen taken as a. basis, the conclusion might be reached that active work in insalubrious regions has a good influence and is even necessary for the health. It is also true that high pay often leads to excesses of all kinds on the part of those who draw it. It is the duty of commanding offi<'ers to prevent this by allowing the soldiers only a part of the sums earned. The balance of the money should be deposited in the corps-chest and paid the men at the end of their colonial service, unless those interested prefer to send the amount of their savings to France. Worlcs of Excavation and Defense require a greater ex- penditure of energy, are always executed on the exterior, and in paludal countries have the additional disadvantage of ex- posing the soldier directly to the emanations from the soil. In this respect there is a considerable difference between low and marshy countries like those of Indo-China, the West Coast of Africa, and the littoral of Madagascar, and dry or elevated countries like the high plateaux of the Antilles, or the coralline and i)ermeable soils of the oceanic islands. Dutrouleau observed long ago, and after General Donze- lot,that work in healthy places, even during the warm hours, was beneficial to health. The fortifications constructed in the volcanic fornuitions of Guadeloupe and Martinique, in 1840 and the following years, had no other effect than to improve the health of the troops. It was the same, later, when Camp Jacob was established. The fact is easily proved. The fusiliers de discipline in service in the Saints 78 Hygiene of the Soldier in the Tropics. and in M;utini<|ne, altlH)ny the troops entailed a mortality of 115 per 1000, in a corps of ;^()00 men. More recently, in Tong-King, hundreds of deaths have occurred among the men employed on the defensive works at Phu-ly, riiulang-Tuong, Lang-Kej), ("hfi, etc. In 1840, during the little exj)edition wliicli h'd to the occuj)ation of Nossi-l>e, there were a few eaith works to establish. There was such a reci luh'sceuce of fevers that ><0 men were lost in a very short time. The deplorable results of the attempts made by th.e whites to handle the virgin soil of Madagascar are known only two well. "Who moves the soil in a |>aludal country," said Lind, two hundred vears ago, "digs there his grave." It has been Hygiene of (he Soldier in the Tropics. 79 proved by experience that Europeans can perform laborious tasks under any meteorological conditions provided they are protected from the influence of the soil. This was the case with the sailors of the Madagascar flotilla, who, in 1885, and again in 1895, led the roughest sort of life on the river gun- boats and at Tamatave and Majunga. The mortality was much less among these sailors than among the soldiers living on the land. In paludal countries the European cannot work the soil; native coolies should be exclusively used in the construction of earth-works, and only the want of manual labor justifies the use, with discretion, of the native troops. It should never be forgotten that no race is absolutely immune to paludism. The opening of the famous canal joining Chandoc to the Gulf of Siam would formerly have cost the lives of 80,000 Annamites. The Panama Railroad has seen as many Chinese die as there are ties in its road-bed. Bear in mind also the mortal- ity among- the Marocains in the Haut-Fleuve at the time of our first cami)aigns in the Soudan. The conclusion is that in hot countries, especially pal- udal countries, reservation must be used in the measure of fatigue to impose upon white troops, and even upon native troops, if their health is to be preserved. But it does not fol- low that they should be left unoccupied and inactive. The ability of the commander will be shown by keeping his troops constantly in good condition without exhausting their strength. Even in times of epidemic it would be a great mis- take to allow the men to abandon themselves completely to idleness and ennui, anxious for the morrow and consumed by inquietude. From ennui and inactivity to the complete loss of the appetite is only a step, and when the ajipetite is gone, disease is near at hand. 80 Hygiene of (he Soldier in the Tropics. As for eaith-woiks, it must be known when to put a stop to them, in war as well as in peace, since it is a fact that in paludal countries their inlluence has been more fatal to the troops than the most murderous epidemics. It is a long time since the habit was renounced of allow- ing colonial soldiers to work for the inhabitants. From the standpoints of health, morality, and discipline, this measure can only be applauded. The working of the ground was above all the most pernicious and naturally the most in de- mand. It would be veritable folly to go back to such a system, and it would be less excusable to do so in our time, as it is impossible to plead ignorance of the dangers incurred. § III. Bathing. In the Tropics, especially after work, as much to rid the skin of the products accumulated by perspiration as to carry off a certain amount of heat, the bath is at once a necessity and a benefit. It enables a man to struggle with advantage against the numerous eruptions which overrun the skin. Under the forms of douches, baths, immersions, and sprinklings, the men ought to find in every post the means of giving themselves total ablutions daily. In France, recourse is had to the Haro process, which can be easily and cheaply placed in the smallest barracks. It furnishes douches for the men at very small expense. By unmans of a suction and force-pump furnished with a nozzle or sprinkling-hf^ad, the soldiers are sprinkled with a mixture of hot and cold water. The fire-pumji. in the colonial posts, is entirely adapted for this use and also for filling the reser- voirs and apparatus of the douche. It is in the morning, between nine and ten o'clock, before the second breakfast and after the hours of exteiior service, tlint the men, in gionj^s, should present themselves at the Hygiene of the Soldier in the Tropics. 81 douche and at the pool, ^\'ith the approval of the medical authority and the commandant, especially at certain epochs, a second hydropathic seance mio-ht be held at tiye o'clock in the eyening. These seances should be short, only a few nun- utes; they should not be obligatory unless demanded for cleanliness. It ^yould even be proper to forbid the douches and cold sprinkling to soldiers recently attacked by diarrhoea or suffering from intermittent feyer. For a subject in these conditions, or eyen one ill-disposed from paludal causes, a douche or a cold bath would suffice to produce a return of the attack. Hot or cold baths in bath tubs are not in fashion in the barracks, outside the infirmaries; the same may be said of sea and riyer baths, in spite of their advantages as exercise and as a stimulant to the system. In the colonies they are either not very practicable or dangerous : not A'ery practica- ble when the price is a long walk; dangerous on account of the sun, the crocodiles, the sharks, and a thousand noxious fish, none the less to be avoided because less formidable. It is already known how freiiuent are the deaths by drowning among our colonial soldiers. There is a veritable danger in permitting men to bathe alone. More than any- where else, they should be positively forbidden to do so in the hot countries. § IV. Amusements and Best. To preserve among our soldiers of the colonial army the health of the mind, which is as indispensable as the health of the body, it is necessary to provide them in the barracks with all the distractions compatible with the profession of arms and the exigencies of discipline. One of the first things deserving favorable consideration is the establishment in all the posts of little libraries. With good will, the money could be found, even by appeal to the 82 Ili/fjiene of the SohJier in the Tropics. liberality of the officers, non-commissioned officers, and colo- nists, and, above all, to the aid societies. To the libraries should be added a few games of dominos, checkers, and loto. The ideal would be the union of these various attractions in a special room, which would become a sort of club for the men, advantageously replacing the exist- ing canteens. There, each one would be at perfect liberty to rest, read, amuse himself with the various games, and attend to his correspondence. Keading-rnoms have been installed in certain barrat-ks in France, but it is in the English and Dutch colonies that models of this kind are found. In Java, for example, the canteen is a very airy place, situated in a large garden provided with the various games which the soldiers love — bowling, lawn-tennis, etc. There is also a billiard- table; theatricals, always so pleasing to the soldier, concerts, and even balls, are encouraged there. It is the only ])lace v.here the Dutch soldier can get spirituous drinks, and he is allowed to get only a very small (juantity; in return, he obtains tea, cotfe(\ and lemonade nd lihituin and at a very low price. It may seem difficult lor us to create institutions of this nature on account of our customs and of the i>rotectiou att'oi-ded local commerce in our colonies; all military com- manders have at least the right to try it in the inclosnre of the barracks. The end to be attained is to draw tlic soldiers from the allurements of the saloon and to seek to amuse them while preserving their health. Rest in the colonies should be taken in two installments; one at night, the othei- in the daytime. The latter, the siesta, has its partisans and its detractors. Still, as far as concerns the soldier, rising at tive o'clock, doing guard duty at night and attending drills duiing the moiiiiiig. a little icst or even sleeji is a nccci-sity about mid- Hygiene of the Soldier in the Tropics. 83 day. It is not only absolutely harmless, but, practiced with discretion, the siesta can have only a favorable influence ujion the health. As for rest at night, its duration can never be abridged without inconvenience. For this reason, nocturnal exercises should be extremely limited. Night marches, unless de- manded by a superior interest, should be proscribed. 84 Hygiene of Ore Sohlier in the Tropics. CHAPTER Y. Medical Service. To anticipate (Jisease.s by appropriate measures is not suflHcient; tlie development must be opposed and tlie gravity appeased by giving- the most careful attention to the sick. This is accomplished by a judicious organization of the medical service. § I. Medical Personnel. The personnel distributed in each colony ought to be suffi- cient to assure the working of the entire military medical service. The jtroportions should be based not only upon the effective strength, but also upon the number of posts, the grouping or dissemination of the troops, and the difficulty of communications between the different posts. Medical Officers. — ^The number of officers of the Medical Department should be great enough to permit the assign- ment of one wherever there is an isolated grouji of at least <)() men. In France, an infantry regiment of three battalions, united or scattered in two or thre§ garrisons, includes: I surgeon of the 1st class (niedecin principal de la Marine); 1 surgeon of the 2d class (medecin de Ire classe de la Marine) ; 2 assistant surgeons ( infdecin de 2e classe de la Marine) ; making 4. In tinu' of war this number is raised to 9,000 men, scattered by battalions and companies, always in movement, often in war. The Europeans have barely 25 surgeons — that is to say, less than 2 per 1000 men; the natives, with only 83 for 25,000 men, are still less favored. It is not possible to demand too strongly: 1. An increase of the number of medical officers. 2. An augmentation in the number of superior officers to direct the service. There might be adopted for each 3 battalions of 4 com- panies the following: 1 chief surgeon, 2 surgeons of the 1st class, and 3 surgeons of the 2d class; total, 0. The distribution could be made thus : 1. In each regiment of 3 battalions, 1 principal sur- geon as chief, with the senior surgeon of the 1st class ready to replace him. 2. In each regiment of 2 battalions, or in the case of 2 battalions combined, a surgeon of the 1st class. 3. In each regiment of 3 battalions, 3 surgeons of the 2d class; and for each regiment of 2 battalibns^ 2 surgeons of the 2d class. The number of surgeons of the 2d class could be varied 88 Hygiene of the Soldier in the Tropics. according to coluiij; it slioiild be based iipuu the number of postt* to be supplied and the condition of the country occu- pied. It could be reduced in Reunion, the Antilles, and Guiana; in Indo-China, on the Coast of Africa, and in New Caledonia, it should be the regulation number; in Madagas- car and the ?!oudan, it should always be increased. The number of surgeons necessary for regimental ser- vice in the colonies, in our o])inion, is as follows: For Service wiTh Troops in the Colonies. Chief Surgeons 4 ^ fqj- Surgeons of the 1st Class '...'.['. 13 f European Surgeons of the 2d Class 19 \ Troops. Total "i^ Chief Surgeons ... g 1 poj- Surgeons of the 1st Class. 14 ( Native Surgeons of the 2'J Class 22 ) Troops. Total 42 This would be an increase of 20, certainly not excessive. It wrts. In connertion wilh colonial expeditions, Ave shall have occasion to s]»eak of the number of surgeons to be i)rovided for the performance of duties outside of those direct Iv con- Hygiene of ilie Soldier in the Tropics. 89 nected with the troops — viz., in the field hospitals, on trans- ports and hospital-ships, at sanitaria, and, in a word, all duties connected with sanitary measures. Nurses. — The number of nurses with the colonial troops should also be increased. In France and in the colonies, each European regiment has a regimental nurse from each battalion, chosen from the most capable and best instructed of the auxiliary nurses. Unfortunately, the native regi- ments are too often unprovided with them. The auxiliaries among these troops are rather coolies than nurses. How- ever, Europeans or natives, regimental nurses or auxiliary nurses, they are not professionals, but are only improvised. Now a nurse can no more be improvised than a surgeon. In the short term of service there is not time to teach them enough to enable them to perform their delicate func- tions. Among the auxiliaries are found some who are very useful as bearers or hospital attendants, but there are scarcely ever professional nurses. Now, in the colonies, espe- cially, the surgeons, often isolated, need excellent assistants, capable of training and directing a certain number of natives. The Annamites and the natives of Tong-King make excellent hospital nurses when they have had the necessary practice. There should be, then, in the colonial army, a corps of nurses like the corps of surgeons — that is to say, a corps of professionals. This body should include ad- jutants, sergeant-majors, sergeants, corporals, and nurses of 1st and 2d classes. Nurses of the grades of adjutant and sergeant-major could be detached to the small posts without a surgeon, and could render the greatest service in such a case. There should be 1 sergeant per regiment, 1 corporal per battalion, and 1 nurse per company. In a column, these non-commissioned oflScers, with the 90 Ili/yieiic of ilie Soldier hi fite Tropics. auxiliaries and the bearers, would form, under direction of the surgeon, a sanitary pcrsoiuid ecjual to all exigencies. The organization of the nurses of the fleet serves as an example: the non-commissioned oflicers, who are profes- sional nurses, are assigned alone to small vessels, such as the torpedo despatch-boats, and the service is efficient. As for ships provided with a medical officer, they always have a suitable number of instructed and zealous nurses, precious auxiliaries of the medical service either afloat or ashore, in case of debarkation. § II. Hospitals and rnfirinaries. In the great centers, the colonial hospitals of to-day are fairly comfortable. Like the barracks and -other military constructions, they might be classified: good or indifferent, as (juarters, in our possessions the least badly provided; in- sufficient in certain respects; sometimes defective. All the criticisms made in regard to the colonial bar- racks might be repeated as to the old hospitals; it is proper, however, to acknowledge that real progress has been made in construction. As for the installation and interior management of the wards, the regulations governing the cleanliness and salubrity of the hospital establishments in France are applicable to the colonies. It must be added, however, that in the colonies, more than anywhere else, care should be taken to provide: 1. A system foi- the prevention of illicit communica- tions between i)atients and the exterior. 2. Si)ecial wards for dysenteries. :>. Pavilions foi- contagious diseases. 4. Rooms for the insane. T). SjKMial vehicles and litters for transporting the l»at ients. Hygiene of the SnhJier in fhe Tropics. 91 We do not dwell upon disinfection appliances. While they pertain to the city, they naturally find their place in the hospital, where they could be kept, and i)laced at the disposi- tion of the representative of the council of hygiene in case of need. Several of our large hospitals are provided with them. If the colonial cities are generally sufficiently favored with respect to hospitals, it is not the same with the smaller places and the military posts. Hospitals are still found of ancient creation which have not even a room set apart for the care of the sick ; others are better off in this respect, but in Xew Caledonia, for example, the infirmary contains only a few troop beds, and is without chair, table, cupboard — any- thing, in a word, which can recall its special destination. Without exacting luxurious and complicated furnishings, there should alw'ays be a regimental infrmari/, suitable to the size of the garrison, whenever the large colonial hospitals are not in proximity to the barracks. This should also be the case in posts which have no small hospital annexed to the ipiarters, such as is often seen in Tong-King and Cochin- China. A regimental infirmary, says Doctor Gayet. ought to be separated from the barracks by a yard, and should be far from noise and odors. It should always be of more than one story. The ground ttoor should comprise: 1. The quarters of the non-commissioned officer in charge of the infirmary. 2. A waiting room or large hall with benches for the fatigued and lame men. 3. An examination-room, with cupboards containing the instruments, medicines, and records. 4. The office of the surgeon. 5. A store-room for the effects of the sick, the utensils, ■and the supplies of the infirmarv. 92 Hygiene of the Soldier in the Tropics. 6. A bath-ioom with tubs aud douches. Ou the second floor, there should be tive wards, as follows: 1. A ward for fever patients. 2. A ward for the wounded. .3. A ward for venereal diseases. 4. A ward for non-commissioned officers. o. A ward for convalescents. According to the same author, the number of beds should be 3 to each 100 of the effective strength. This num- ber may suffice if it be made to apply strictly to the sick, and the convalescents and those under treatment for venereal dis- eases sleep in ordinary trooj) beds. Such an infirmary should exist only at posts of a certain importance, garrisoned by sev- eral companies. In posts garrisoned by less than a hundred men, a simpler place, with two or three beds, a table, an arm- chair, chairs, and bath, would suffice. It would be well if all our small garrisons were so provided. In case of contagious disease, one or more huts can be erected in which to care for the sick. They should after- wards be burned. § III. Materiel of the Medical Department The infirmaries and field hospitals of the colonial posts are not, as in France, in the neighborhood of the hospitals proper. They receive, moreover, a great number of serious cases. It may even happen that the difficulty of communica- tions will oblige the surgeon to keep such patients there a long time. In short, these small hos])itals often have to be used in the same way as the hospitals of ships. Now the war-ship, however small its tonnage, and even when it remains near the coasts, has its medical materiel provided and its service organized. The surgeon possesses personally Hygiene of the Soldier in the Tropics. 93 a surgeon's case, which a monthly allowance enables him to maintain. There is a pharmacy aboard, with apparatus, medicines, and materials for dressings, appropriate to the effective strength embarked. All is foreseen: the furniture of the hospital, the special food for the sick, a field-chest for first aid to the wounded, a disembarkation-bag. and litters specially adapted to medical or surgical needs in case of disembarkation. The ships are no more deprived of medicine than of ammunition, and the first-aid chest is always on hand. Why should the posts in the colonies be deprived of any- thing that is necessary? The instruments are kept in a box, which is often in bad condition. The medicines and dressing materials are often insufficient in quantity. Many of the small posts are even denuded of all means of assistance. Why not put the surgeon at such a place in the same situa- tion as the surgeon atloat? Why not devise, for each colo- nial post, a supply-type of medicines and dressing materials, analogous to that of the ships? There might be adojited, iu addition to the main sup- plies, a series of 4 chests : No. 1, for posts of 10 men, or under. Xo, 2, for posts of 10 to 20 meu. No. ?>, for posts of 20 to 40. men. No. 4, for posts of 40 to 60 men. The model of those to be kept iu store-rooms of colonial hospitals could approximate to the one adopted by the Departments of War and Marine for the supply of forts and batteries in case of mobilizaticui. These chests are always prepared in advance and kept in the store-rooms. In each newly created post there should be oire or more chests, according to the strength of garrison, to be replaced at a fixed date or when there is need, the empty chests being returned to the depot. This system has been praised for the 94 Hygiene of the Soldier in the Tropics. supply of ships; it would be of the greatest service iu the colonies. These medicine-chests should l)e a part of the fixed mate- riel, distinct from the materiel of mobilization, in paniers, which should also be sujiplied, as we shall say later on. It is also necessary to supply for each infirmary or field hospital in the colonies: 1. One or more filters. 2. An ice-machine. 3. Some cooking utensils. 4. Litters or hand-barrows of the style of the country. 5. In certain places a small l)oat for the transportation and evacuation of the sick. <). A very clear manual of instruction in first aid for sick and wounded. In 1886, during the period of the conquest of Tong-King. the medical director of the expeditionary corps, M. Dujardin- Beaumetz, jtrejiaied, tV)r the use of military posts without a surgeon, a clear and concise medical manual, which corre- s])onded ])erfectly to the needs of the moment. Ri^-ent works contain similar and more detailed instructions. § IV. Repatriation of the Sirl: To repatriate the sick, special shijis are required. Th(^ ordinary ships of war, the ships of connnerce most rapid and best furnished for cari-ying healthy i)ersons, do not often ful till tile ic(piisite conditions for the sick. The jieriods of return have not always been judiciously chosen, at least in noinial times. HOSPITALTRANSPORTvS. Fnv many long yeais the r(^j»atriat ion of the sick was acc()in|ilislie(l in a dejiloiabie manner. IJefoi-e ls4(l. in Scneual. nnfoituuate convalescents were Ui//jicne of Ihe Soldier tn. llie Tropics. 95 crowded upon incumbered sailing vessels, often infected with yellow fever, without suitable food, without medicines, sometimes without doctors; they returned to France not by the shortest route, hut lij way of the Antilles and Guiana. Later, during the cami)aign in China, in ISOO, ships of war a little better managed, the Vengeance, the Dri/ade, the Gar- onne, carried out troops and brought ])ack the sick. It was the same during the campaign in Mexico. The large sailers, the Tage, the Navarin, etc., converted into transports, have long performed the service between France and New Cale- donia. The last types used foi- this purpose, the Magellan, the Caledonien, were better adapted and more approi)riate to their special service. They were large sailers, furnished with a little engine to be used in calms. Their maritime existence was ephemeral; as hospital-transports, moreover, their ser- vice would have been much restricted for want of the sick. At the beginning of our occupation of Cochin-China, the Orne, the C reuse, and the Sortlie marked serious i)rogress; and yet, although sufticient for well troojis, they were not adapted for the repatriation of the sick. It was not until November 20, ISTT, that there started from Toulon th<^ first type of the veritable hospital-trans- port, the Annandte, measuring 105 meters in length, gauging ;U00 tons, and possessing an engine of 050 horse-power. Five transports of the same type, the Tong-King, Mijtho, Shamrocl; Bien-Hoa, and Vinh-Long, were successively con- structed at La Seyne. The Gironde and the Nive, constructed a little later, were fitted up to transport cavalry. These eight ships, all of iron, except the Annainite, wer.^ perfectly ada])ted to the transportation of the sick. The upper broadside could accommodate 150 bed-ridden patients, and the 1ow«m" one :^00 convalescents. The system of bedding was good; the ventilation easy, thanks to a system of double 96 Hygiene of the Soldier in the Tropics. partitious aud to horizoutal wind trails, windowed at inter- vals and closed by grooved obturators. Up to 1886, these ships worked alone; from 1886 to 1895, they were employed in connection with ships chartered by the State; actually, ttiey are iinmohilized. They have repatriated about 12,000 sick or convalescents with only 18 deaths per 1000, notwithstanding the dangers of the voyage across the Indian Ocean and through the Red Sea. It may be said that these ships were operated hygien- ical ly. They have rendered service, not only in repatriation, but also as hospital ships in Dahomey and Madagascar. It is particularly interesting to see the service these ships were capable of performing in repatriation. The sur- geons fixed the total number to be embarked at 1000 per- sons, 400 to 500 of whom were sick, half of them bed-ridden. We know this limit was often exceeded', but that was wrong. In the ]Marine, the officers, surgeons, and especially the sick, were unanimous in proclaiming the excellence of the system. One of us. after four passages, two of which were return trips, is of the same opinion; the more so because some of these voyages were made under unfavorable conditions, with 1200 and 1300 persons on board. If a comparison be made between these ships and the chartered vessels, the advantage is not with the latter; while excellent for the transport of well men. they nre inferior as transports for the sick. From 1886 to 1895, the ti:insi)orts of the Srate liave h.i.l a mortality of 18 per 1000, while the chartered ships, for the same number of sick, about 12,000, have had a mortality of 26 per 1000. It is well to remark that, wheuevei- possible, the most serious cases were reserved for the hos|»itMl-tiansports. Hygiene of the Soldier in the Tropics. 97 The utilization of the chartered >s and the placiu^ in reserve of the trausports of the State has thus constituted a progress hacl-ivurd from a hygienic standpoint. AATiether the service of repatriation falls upon the State or upon the commercial companies, it is necessary that the shi])s be fitted up and managed for the special use to which they are to be put. The tieet of transports to succeed the old ought to be litted up conformably to the progress of industry and of naval hjgiene. For the ordinary transport service the type Shamrork might be suitable, with certain modifications. A ship from 125 to 130 meters in length would be better; it could receive 500 sick with more room for isolation, cleanliness, and disin- fection. The lower broadside could have two rows of cots for the less severe cases and for the <-onvalescents; the upper one, a single row for bed-ridden patients. The deck should be reserved for those seriously sick, (luartered in special wards, having a special and imi)roved bedding. Isolation and dis- infection wards would be necessary. It would be well to provide steam ventilators for forcing in the fresh and drawing out the foul air. Distilled water only should be used, for soft water in a hospital, whether ashore or afloat, is a prime necessity. It is necessary then to provide for making it on board in great quantities, and the apparatus uiust assure a constant supply. The question of the manufacture of ice aboard ship is not yet practically solved. For some years, the Rouart, an ammonia system, has been tried in the Marine. An apparatus of this type was tried on the Minerro, at Gabon; another at Kotonou, during the Dahomey expedition; we understand they did not work very well. A Rouart apparatus was deliv- ered to the Shanirocl': but when it came to setting it up,great 7 98 Hijijicnc of the Soldier in the Tropics. difficulties were encountered: in the first jilace, a masonry support had to be constructed; then, detailed instructions were lacking. In short, this ai)]jaratus. by which cold is obtained by the evaporation of liciuetied aniuiouiacal gas, has never worked; it is not practical for ships. The frigori/ic, based upon the principle of the expansion of compressed air, and employed upon certain ships of the merchant fleet for the ]U'eservation of food, seems to be the most practical ajjparatus: a motor, which borrows steam from a boiler, forces air into a compressor cylinder, and makes it j»ass into a detainer. The illumination should be by electricity. The funnel should be enveloped by double partitions separated by free spaces, forming a mattress of air. The water-closets for men and officers ought to be dis- posed as })rescribed by the ministerial desi)atch of the 13th of February, 180.3. A great improvement, carried out upon the hospital-transports of the Shamrorl- type, has been the placing of the closets for the men on the exterior of the ship, permitting the application of the inincijile, Everything to the sea. The kitchens should be i)rovided with all the utensils necessary for the good working of a hospital. A cleaning-room and isolation waids are indispensable. Finally, the mechanical windlasses ought to b(^ icudered silent. CONDITIONS OF REPATRIATION. AMien possible, the time of repatriation should be chosen. Attention should be given to the st^ason in wliirli the voyage is to be made, and to the tinu^ when the ana*mic men, sometimes gi'avely attacked, will arrive in France. These matters are not iiiditTerent. as is al)oni to be shown. llijijicne uf Ihe Soldier in the Tropics. 99 The percentage of deaths is not the same in the voyages made by the same ships at different periods of the year. In making an abstract of the deaths which occurred on the 92 voyages from Saigon to France on board the trans- ports of the State and the chartered vessels, during the ])eriod from 1886 to 1895, we have the following results: Number Number Average Leaviug Saigon. ^^^of^^^ ^^of^^^ ^.P-^^ January ''' '^'^ ^•■^ February 8 35 4.^ March 18 ^-^^ April 6 80 5.0 May 5 23 4.5 June <^> 40 6.0 July 8 fi8 8.5 August 11 ^-^ '^•4 September 10 82 8.2 October ^ 26 4.3 November ^ '^^^ ^-^ December 10 '-^^ ^'^ It is easy to see that the half-year from April to October shows the greater proportion of deaths. The number of voyages was 46, exactly the same as the number during the most favorable half-year, from October to March, which was likewise 46; and nevertheless the difference is more than one- third. During the six months of A])ril, May, June, July, August, and September, we count 32(; deaths, giving an average of 6.7 per voyage; during the six other months, we have only 190 deaths, with an average of 4 per voyage. In the half-year in which most deaths occurred we also remark a notable difference between the first and second quarter. Duiing the months of April, ]May, and June there were 17 voyages and an average of 5.4 deaths per voyage; 100 Hygiene of the tSukUer in the Tropics. during July, August, and i^epteinber. there were 29 voyages and 233 deaths, an average of 8. It is precisely the quarter in which most deaths occurred that shows the greatest number of voj'ages! This fact is curious, or at least hizarre. The reason might be found in the fact that at this period of the year the number of sick is greater in the colonies and the cases re(iuiring repatriation are more grave. The mor- tality is, in fact, much greater in Indo-China, in the corre- sponding periods; were it otherwise, the matter would be incomprehensible. In studying the figures given by M. Bonnafy, upon the mortality on board the transports and chartered vessels, we find an interesting remark. From 1879 to 1883, when the sick rei>atriated from Indo- China all or nearly all came from Saigon, when only six voy- ages were n.iade a year and the state transports were ex- clusively used, only a slight difference in the mortality is observed during the passages at different seasons of the year. Thus for 31 voyages made in five years, with 5399 sick and 95 deaths, or 17.0 per 1000. the following is the record: -- . 1, . Mortality during Leaving baigon. tlje Voyage. January 12 per 1000 March 10 per 1000 May 10 per 1000 July 18 per 1000 September 17 per 1000 Novembei- 22 per 1000 It should be stated thiit it is difficult to form pioper con- clusions based upon a relatively small number of sick and a rathei- limited number of voyages. The proportions are sh(»wu under a different aspect in Hygiene of the Soldier in the Tropics. 101 coiisidei'iiifr the voyages made fioni 1SS() to 1895, in the evacuatiou of all ludo-Chiiui. In 92 passages by the transports of the State and the chartered vessels, with 22,0(55 sick and 51(» deaths, or 18 per 1000 on the transports and 26 per 1000 on the chartered ves- sels, the following is observed : '. Proportion of Leaving Saigon. Deaths during the Voyage. January 21 per 1000 February 13 per 1000 March 12 per 1000 April 15 per 1000 May 16 per 1000 Jnne '29 per 1000 July 33 per 1000 August 29 per 1000 September 35 per 1000 October 20 per 1000 November 19 per 1000 December 17 per 1000 The least mortality is observed during February. ^lareh, and April; beginning with the month i»f ^lay, the increase is progressive until October; during November, December, and January, the projiortion is a mean between the two extremes. In short, the most favorable season for repatriation is that of the months February and March; the dangerous period, June, July, August, and September. The reason is easily seen. In the Indian Ocean the southwest monsoon is very cool; the sea is rough, the air sharp, and diarrhoea reappears. In the Red Sea the heat is overpowering, because there is little breeze and it comes from behind; the heat adds a particular stamp to the dis- eases, it depresses certain cachectics and deprives them of all resisting power. 102 Hygiene of the ISohlier in the Tropics. In a general way it may be said that the danger of the passage results above all from the gymnastics which should be executed by the skin and the lungs in order to put tht^ body in equilil)riuni with the surrounding medium. If the temperature jumps up ten degrees and remains there for sev- eral days, the cutaneous and pulmonary excretions ought to increase in order to prevent the heat from being concentrated in the organism; this increase of excretions does not take place in the case of men who are too weak. There is an aggra- vation of the condition of the sick; it is not unusual to ol)Serve convalescents overcome by the heat, and a form of delirium which impels cachectics and paludal patients to throw themselves into the sea. September is the worst month, because it is the hottest in the Red Sea. The higher the sun is, at noon, the higher the temperature; but it is easy to see that the highest tern peratures art^ slightly later than the miximum height of the sun, which is, however, a general rule of Nalni-e, the ett'ect being always posterior to the cause. The transports of the State were well conceived from the standpoint of hygiene, l)ut were very faulty in regard to speed. Remaining in the nc^ighborhood of the equator is a real hardship for tlu- sick, and the shi}»s of repatriati<»n should have great speed in older to cross the dangei-ous zoni' most rapidly. If th(^ time of ci'ossing the hot seas is not a matter of indifference to the sick, the time of arrival in France has also its importance, ^^'in1er is an unfavorable season, and if it is desired to counteibalaiice the bad etVects of the shari* cold of the (-(tuntries of the North, it is useful to keep the sick for some time in the South. .Men who returned from the colonies in a relatively satisfactory condition frey the medical authorities. Formerly the ordonnafcur, or chief of the health service, represented the surgeons in the council of hygiene; but it is evident that he could not re]»la(e them. This anomaly has been suppressed, and with reason, for it is well that each should have the responsibilities of his own functions. At the present time, in commissions of hygiene, there is place for the i»resident of the council of health, the surgeon of the local service, and the surgeon of the nrraisso)ieinenls; but they ai'e not all: the municipal council, the giMieral coun- cil, and many other military or civil services are represented there. When it concerns a question of general interest, there is nothing to be said; but in certain cases, Avhen the public health is alone at stake, it is to be feared thai a com- mission so composed might be insjtired by considerations foreign to the subject. . , Hygiene of the Soldier in the I'ropics. 105 Would it uot be better to have a permanent commission, whicli could submit, upon occasion, its opinion, with the reasons therefor, to the governor, charged with making a decision? We willingly share the yiews of Doctor Simon relative to the reform of councils of hygiene, and propose to replace them by a commission made up as follows: The chief of the service of health, president; the chief of the service of phar- macy; the chief surgeon of the troops; a civil surgeon; a civil pharmacist; the two latter chosen by the governor. This purely technical commission, in which the inter- ests of local commerce and of the municipality would find competent defenders, could give a hearing to such persons as it might desire to consult — surgeons, functionaries, av otti- cers — and immediately present its report and conclusions to the governor of the colony. In case of threatened epidemic, and, above all, of epi- demic invasion, there would thus be avoided many idle and sterile discussions, too often ending in the adoption of use- less or incomplete measures, or even measures contrary to prudence. The governor could call for the opinion of the commis- sion of hygiene whenever he considered it necessary to do so, and could convoke that body in case of need. It is not only indispensable to protect the colonies against the invasion and spread of epidemics, but it must not be forgotten that ever}- contagious disease implanted in one of our possessions becomes a menace to France, on ac- count of the rapidity and frequency of communication. The prevention of epidemic diseases cannot be accom- plished by following an invariable formula. 'To combat them with equal energy in all places would be an error of geography; with equal energy at all times, an anachi'onism.'' 106 lii/(/icnc of llie Soldier in llic Tropics. The system of prevention vvhicli ought to be inspired in its details by circumstances and places comprehends: 1. Ad- ministrative measures; li. Hygienic measures. § II. Admin isfraiive Measures. More authoritative in character than hygienic measures, as M. L. Colin says, the administrative measures would be contrary to the dignity of man, if they alone were employed. Joined with hygienic measures, they are perfectly justified, and may be classed in four groups: 1. The evacuation of epidemic centers. 2. Vaccination. 8. The isolation of contagious diseases. 4. Quarantine. EVACUATION OF EPIDEMIC CENTERS. In the presence of certain menacing or declared dis eases, the council of hygiene has the right and the duty of preventing assemblies of recent arrivals in the town which is attacked or is under suspicion. The gatherings resulting from the approach of festivals, pilgrimages, etc., should be dissolved, and these solemnities prohibited in case of need. Finally, in the general interest, and aside from extra hygienic prejudice, the council should, above all, order the immediate withdrawal of the troo]»s fiom the centers of population. It was by withdiawing the soldiers of the white race from Vera Ciuz, during the expedition to Mexico, that the frequency of the yell(»w fever was diminished. In 1SS4, M. L. Colin did not hesitate to i-ecommend tiie sending t<» their homes of all the soldiers of the Army of Paris who weic even simply indisposed, to preserve them from the cholera which menaced the garrison. This would l)e a measure to take in our ]>ossessi(»ns in Indo-China, whenever there is cause to fear the approach of Hygiene of the Soldier in the Tropics. 107 cholera at the centeis. It is, moieover, what is doue in case of yellow fever in our colonies of the Antilles. When the evacuation is ordered, it is an advantage to proceed before the appearance of the plague among the men ; otherwise they carry the disease with them and propagate it. To obviate this dispersion of the plague, it is well, at the time of the evacuation, to isolate the troops by establishing sanitary camps, analogous to those which exist in India, tUiadaloupe, and Martinique. It must be remembered that soldiers can not be camped in the open air, in the colonies, as is done in Europe. It would also be wise, until we shall abandon the towns of the plains for the heights, to erect suitable buildings in these [tosts of refuge. Now, the huts provided for this use, not- withstanding the serA'ices they have rendered, are often in a state of dilapidation which renders their occu])ancy more dangerous than efficacious, and conditions are sometimes found propitious for bringing to life the germs with which the troops placed there are impregnated. In Indo-China, in time of cholera, there is a cause of propagation which has not received sufficient attention. This is the possibility of the dissemination of the disease by the natives employed during the day at the European homes in the towns. In the evening, these natives return to their villages, which are often decimated, at certain epochs, by the Asiatic plague. The measures to take, in such a case, seem to us to again depend upon the council of hygiene. It is the same with measures relative to the agglomera- tions of natives, principally in the localities inhabited by Europeans. VACCINATION. Variola is spread in our colonies to such an extent, and has caused such ravages among the populations subject to 108 H i/fjiene of the Soldier in the Tropics. our control, tliat, in their interest as well as in ours, on account of the contagion which is always possible, it has long been a duty to regulate, and even to order, vaccination in our colonial possessions. Vaccination works very well in Indo-China, especially since the creation of a vaccination center at Saigon, the bene- fits of which extend over all the Far East. Vaccination has also been instituted in Senegal and in the Soudan; the Canacjues, in New Caledonia, have also been vaccinated. It is important that administrations as well as popula- tions be impressed with this truth, expressed by L. Colin: Prevention by vaccination is not assured by the performance and success of a single ojieration; even when successful, it constitutes only the first term of the series of inoi-ulations to impose upon each subject. In short, revaccinations are indispensable; and if this belief is impressed with difficulty on the minds of the free native populations, we ought never to lose sight of it as far as our native military contingents are concerned. ISOLATION. The construction of isolated pavilions for persons at- tacked by contagious diseases has not always been thought of in the colonial hospitals. It is certain, however, that iso- lation is an efficacious measure of prevention. In the absence thi<-k to he completely penetrated by the sulphurous vajjor. After having- found the cubiral contents of the room, closed the openings and seams, opened the furniture, spread out the hanginj^s and all the objects to be disinfected, the sulphur, at the rate of 40 grams \)ev cubic meter, is placed on common plates and s])rink](Ml with a little alcohol; it is then set on tire, and one r(4ires through a door left free. This is immediately closed and all the joints stoi)ped up on the out- side, in case the sulphurous vai)or is seen to tilter through. A good precaution to take at the outset consists in sprink- ling the floor and walls of the room to be disinfected, which favors the development and action of the sulphurous acid. The room remains closed at least twenty-four hours; it is then opened, washed, dried, and all the objects it contains are aired. Another excellent means of disinfecting contaminated rooms is to wash the floors and w^alls with a large sponge saturated with an alcoholic solution of bichloride of mercury of 1:1000. After this washing, they are allowed to dry, and are then repainted and whitewashed. This disinfection ought to be carried into all the angles and crevices, without leaving a nook not penetrated by the liipiid. It should pre- cede all sweeping and cleaning. For painted surfaces it might be followed by a washing with ])otash, and even by scraping. The atomizers long used for this ])urpose had i)erhaps the advantage of spreading the liquids more uniformly; but it has been observed that they do not cause a sufflcient pene- tration of the surfaces, at least unless they are allowed to play for a long time on the same spot. Those who are charged with these operations should 116 Hi/fiir)i(' of the ISoldier in the Tropics. remembei 'that they are liaiHlliii^- deadly poisons and should be careful not to carry their hands to the mouth; when all is finished, they ourees. In the small places, a suitable apjtaratus can be constructed at very little expense, in a manner described by Doctor Richard, a chief surails tilled with a solution of bichloride of mercury of 2:1000. It is allowed to icmain there twenty-four hours, and is then j)Ut in boiling water to remove the bichhuide of mercury. The bichl(»ride solution is haiinless to clothing, hang- ings, and objects of e(|uipment; this is not the cast\ however, with boiling watei-. Objects susceptible to iujui-y should not, then, be boiled, but oidy the linen. Moreover, the Hi/(/iene of the Soldier in flic 'rroi)ics. 117 objec-ts which would he iiijnied by boiling are jjjeiieiallv imu'h less contaminated. It will snttice to leave them for an hour or two in the solution and then rinse them with soft, cold water. The wool of mattresses is likewise susceptible to injury; it should be disinfected in an ordinary or improvised stove by the use ol steam. All persons who have ai)])roached the siclv. whether acci- dentally or in a continuous manner, should disinfect their clothing before resuming- ordinary life. The (piestion often arises as to what objects it is possi- ble to disinfect and what it is ])rudent to destroy. After a slight epidemic of cliolera on board, one of us proceeded in a manner which may serve as a guide. All that had been in immediate contact with the jiatient and was manifestly con- taminated by ejections or sweat was destroyed; all tliat was not so polluted was disinfected. By acting thus, we believ(^ unnecessary destruction can be avoided without sacrificing the rigorous conditions of hygienic requirements. Disinfection of Objects and Utensils Used hy the Sick. — The glasses, plates, cups, canteens, forks, and all articles which have served the sick, should be washed in a solution of sul phate of copper and then placed in boiling water. Disinfection of Ejections. — The alvine discharges and the vomitings should be collected in porcelain receptacles at the bottom of which is left a disinfecting solution; enough solu- tion will be added to cover them comi)letely. They should never be thiown into the latrines, nor into rivers, but into holes dug for the purpose. There they should be immedi- ately covered with lime, charcoal, and earth. Disinfection of Cadavers. — In case of death, the cadaver should be rajiidly and thoroughly washed with a bichloride solution, and then envelojx d in a shroud saturated with the 118 IIt/(/ici)C of the ^Sohlier in the Tropics. same solution. The sawdust from the bier, with charcoal added, should likewise he thoroughly saturated with the same solution. Prophi/tactic Disinfection of PersonneJ and Materiel. — Those who are called upon to attend the sick should be chosen from among the most courageous and most intelligent. If it is a question of typhoid fever or of variola, men will be chosen in preference who have had these diseases. The hygienic instructions ought to be explained and rigorously carried out. As for those who are necessarily brought into contact with the patient, they should be extremely careful in regard to cleanliness, above all avoid- ing carrying the hands to the mouth; they should wash often, with the bichloride solution or with suljihate of co])]iei-, noi only the hands, but also the face. Soldiers employed on this service should have no communication with their comrades, still less with those outside. They should receive special food and supplementary rations. The clothing of the attendants should receive the same disinfection as that worn by the })atients. "* The litters, vehicles, and boats should be disinfected in accordance with their character; for that purpose a special atomizer may be used with advantage. SANITATION OF LOCALITIES. Tlie sanitation of localities — and. we would willingl.v add, of ]>opulations — is a necessaiy precaution. It will serve to rendej- the invasion and extension of diseases, whatever their nature, less frecpn-nt and less formidable. It is known in I']uro|»e. especially in England, that a <-<)nlagious disease has less chance of gaining a foothold, when the country is refraclon', or is, as is said in p]ngiand with reference t(i. cliolera, clidlcrd-proof. The most h\gienic towns are those which have an ii-re- Ifi/fliriic of the Soldier in iho Tropics. 119 pi'oaehable potable water, a. system of diainaj;e and cleauiug to prevent the soil from being polluted; those where sewers are kept in good order and the lodgings and sales of drinks supervised; where vaccination is prescribed and the exam- ination of public women is regularly made; those, in short, wiiirli have abattoirs well managed and well located, suit- aide hospitals, suftii-ient means of disinfection, and special vehicles for those who are sick with contagious diseases. In such towns, hygienically constructed and hygienically gov- erned, the mortality diminishes year by year. In the colonies, where institutions and customs of this kind are more nt^cessary than elsewhere, everyone knows what really exists and divines what ought to be done. With the exception of Saigon and a few new centers in Tong-King. most of our colonial towns are regular sewers, where care for hj'giene is a thing unknown. The local administration is not stimulated by the fear of seeing the garrisons sup- pressed, and it often opi)oses a great force of inertia to the just demands of military authority. The council of hygiene is never consulted except upon the approach of an epidemic, although all (juestions concern- ing the health of the troops and inhabitants should be regu- larly submitted to it. Every vexatious thing that happens in the colonies is charged to the soldier, and the question of what diseases are given him is never raised. If the towns of the littoral weie to be evacuated and the troops placed in the health cities, upon the heights, many of tln^se inconven- iencies would be avoided. The municipalities themselves would understand what they have to do in the way of quar- tering the troops, and what would be necessary to keep the ones remaining with them. Tlu^ conditions of living and of general health would be more satisfactory for all, and the measures of edileship and of urban hygiene would benefit the whole poj»ulation. 120 ]I //(/ii'iie of lite ^oldti'f in Ihe Tro/jics. CHAPTER VII. Special Measures for Expeditions. When an exjiedition is undertaken in a coniiti y beyond the seas, it is necessary to be informed of all the difticnlties to be overeonie. In considering the climatic and telluric dang^ers, a <»eneral formula Avill not suffice; even in the sann^ latitudes, the hot countries ar*^ subject to vaiious conditions and influences, and the means of })reservation are different. San Domingo and Mexico awaken thoughts of yellow fever, and the Euro})ean about to be exposed there would be guilty if lie dirincii»a]]y against malaria that ])rotec- tion is needed. Tile judicious apjtlication (»f scientific information ui»on the distiibutioii of diseases in the world is caj)abl(\ in itself alone, of averting great disasters. The French exjM'dition to San Domingo, at the beginning of this century, might have had a ditfei-eiit ending from that which history i-ecords, if the conditions of the genesis and ])i(>pagat ion of yellow fever had been bettei- known. Our exjiedition to Mexico, so murderf>us in the beginning, would have been much more so if it had not been remembered (hat yellow fever ne\t'i- quits the littoral to advance into th<' inteiim-. What would have ha])pened without the Convention of Soledad. which permit- Hygiene of the Soldier in (he Tropics. 121 ted the nniiy to leave the hot lands for a less dangerous zone? Every expedition in the hot eonntries, whether it be within the limits of one of our possessions or upon foreign shores, should be wisely and ])rudently studied before being decided upon and undertaken. § I. Colonidi tJ.rpedifions. There are two kinds of colonial expeditions: the tirst are local in nature, constituting a condition of canijiaign for the whole or a part of the local garrison, whether it concerns the suppression of a rebellion or the extension of our in- fluence over the neighboring countries; the others are those great expeditions decreed by the (Tovernnient with a view to oi>erating in the Tropics, or in a region in order to eon- (juer it. In the tirst case, all ought to be arranged in advance; the colony in mobilizing its military forces, should have a well-determined ])lan providing for all necessities. In the case of a distant expedition, a cohmial expedition proper, the first care, after the operation is decided u])on. is to choose the chief and to judiciously constitute the head of that complex organism, an expeditionary cor]>s. In the tirst place, the chief of the expedition ought to be chosen, without regard to any irrelevant prejudice, from among those best qualified by reason of their antecedents and individual service. To this chief should bt^ added three assistants: a chief of staff, an olticer of the administrative service or commis- sary, and a surgeon. Upon this body, constituted as a su])erior staff, is to fall, thenceforth, the })reparation of all the details of the expedi- tion, each member being more especially charged with the (piestions relative tc his own de]»artment. 122 Ilm/iciir of llio Soldier in the Tro})ics. It is indispensable for this staff to have a sufficient knowledge of the countiy where the operations are to take place; otherwise, it would be impossible to make proper ar- rangements for quartering, camping, subsisting, clothing. and eipiipping the troops, and would be difficult to prepare for supplies and transports. In order to attend to the smallest details of organiza- tion, to receive the troops upon their arrival from Europe, and to superintend the arrangements ]»relimina.ry to active operations, the connuander-in-chief should be one of the first to arrive at the base of operations. The English, whose practical genius we cannot help admiring when it is a (luestion of organizing a colonial ex- pedition, have taught us valuable lessons. After many re- verses sustained at the end of the last and the beginning of the present century, due to a disdain of hygiene and cli- matology, our neighbors have luotited by tlu^ lessons of experience; it is known how they have succeeded. It is well to be inspired with the general spirit which characterized one of their most fortunate expeditions, both from a military and sanitary point of view. The commander-in-chief arrived at the base of opera tions more than a month before the ex]ieditionary corps, accompanied by a. technical ]irrsoiiiicL including a large numl»er of surgeons. He made sure of the application of all the necessary measures to ]»i-eserve the tr(M)]>s from variola and yellow fever, lie also had a ship fitted uj* to serve as a floating hospital and |>rescribed a system to be t'ollowed in removing the sick. The ti-oo]»s were to airixc in the good season, with a uniform ai»piopriate t(» the torrid clinnite: a shoit and roomy tunic of llannel or of gray serge, with long side pockets; trousers of the same nuiterial, closed to the leg by leggings Hyqienc of the Soldier in the Tropics. 123 of browu holland; and a light heluiet. Each man carried, in addition, two shirts, a flannel band, a waterproof, a small pocket filter, and an air Alter, intended to be placed before the month to prevent the absorption of miasma. Moreover, each soldier was in possession of a clearly worded hygienic manual relating to the personal hygiene of the soldier. Numerous bearers had been enrolled for the service of the columns, and the route to be followed was marked by halting-places 20 kilometers apart. At each of these places was found a camp capable of sheltering a thou- sand men and composed of large huts with circular camp- beds, upon which 50 sleepers could stretch themselves out comfortably. Each of these halting-places included also a special hut for the officers, store-houses, a field hospital, kitchens, a water supply, and a large filter. This campaign, so skillfully prepared, was that of Ashantee. It is a custom to cite it as a model, but it is not alone. Begun in January, 1874, it was finished in March, and on the 23d of that month the European regiments again took the route to England. General Wolseley had operated rapidly and with a sacri- fice of only 65 lives out of a force of 4000 men, of whom 2000 were Europeans. Later, and not far from the same place, the administra- tion of the French Marine was largely inspired by these principles. General Dodds attempted all, but with less per- fect means of putting them in practice. He was also at a disadvantage in having younger troops. Our two campaigns in Dahomey were likewise well conducted, especially the second, considering the desperate resistance of the enemy and the difficulties of every nature to be overcome. The campaign of 1895 in Madagascar was disastrous, because it was wished to make innovations by attempting a 124 Hygiene of the Soldier in the Tropics. trial of coiitiiienlal war in tlie «jireat Malajj;asy Island! Now, the succ-ess of colonial expeditious will lonji be subordinated, uot so much to skillful dispositions of the most subtle strategy, as to a harmony of absolutely special natural con- ditions and to the observance of hygienic measures. In their last campaign on the coast of Africa, fiom the 14th of December, 1805, to the :id of February, ixm. the English also obtained surprising j-esults. From the re])ort of the surgeon. Colonel AV. Tayhu-, tln^t* were only 7 deaths out of J)!)!) Europeans jn-esent. Adding 'A deaths which oc- curred on the return voyage, there results a total of 10 deaths out of 909 European officers and soldiers, or 1 per cent. Out of 375 natives, there was only a single death, giving 0.25 ])er cent. It is true that this campaign was very short and not at all murderous, which must be taken into account in the com- ]»arisous. However, it is im]»ossible to deny the excellence of the i-esult. >^ II. Clioire of Troops. In the first ])lace, the commander-in-chief should deter- mine the strength and natur(^ of the effective force to set iu motion. It is only ui)on this information, well established, that the accessory services will be able to make their ariangements and tix the limits of their cooperation. To avoid the risk of sending too small a force, it is not necessary to err in the o]»posite dii-ection. Those who had ex])erience of the country asked themselves, witli reason, before the ^Madagascar ex]tedition. if it were really net-essary to mobilize 15,000 men to tight the Hovas. esjMMially as the difficulties of snj)j»]y seemed \vv\ great. \\\\\\ 4000 wtdl- clioscii Fui-o])eans and SOOO nativt^s the work would have been easy. The effective force to be em])loyed liaving ou(m^ b(^en 11 i/i/ifiif' iif llie Sohlicr ill fill' Tropicfi. 125 deteiinined, it is necessary to designate the units which are to make up tlie exi>editi()nary corps. Experience shows that these should be talcen from the corps which ordinarily go to the colonies, and accessorily from the Algerian corps. The metropolitan army is not intended for years of age. In all our expeditions, and in the English expeditious too, the same fact has been observed. If in Dahomey, in 1892, the Foreign Legion had only 35 per KKM) invalidations, while the infinilerir tie mariiii' had DO, the tiotilla SO, the artillery 74, the engineers 50, etc., it was be- cause the soldiers of the Legion are older and in consequence more robust. Moreover, they are men inured to all fatigue, little accessible to moral depression, and apt in nmking the best of the most precarious resources. The nuijority of the soldiers of the Marine, on the contrary, are men from V.) to 23 years old who have never served in the colonies, are depressed at the first attacks of paludism, and are more 126 Ilyijiene of Ihe ^Soldier in the, Tropics. accessible to discoiiiagemeiit. Excellent soldiers, full of courage and ardor, they lack bottom, because thev are too joung, because their constitutions are not fully developed, and — we will add with one of th(Mr generals, who will i>ardon us for expressing his opinion, which is our own in all ])oints — because their military instruction has often been too forward. The camjiaign of Madagascar has proved the same thing with regard to troops of different arms and varied composi- tion. It likewise permitted the verification of a fact brought to light in preceding cam])aigns: that it is necessary, to the greatest possible extent, to prefer native trooi»s to white troops, since the former pay a tribute to torrid climates three or four times less costly than our own. Thus the Algerian tirailleurs disembarked KJOO men at Majunga. One battalion of this force was with General Metzinger from the beginning. They brought !)()() l)efore Tananarivo; the men of the Legion were equally fortunate. The 200th of the Line, com]iosed of volunteers from 20 to 22 years old, and for the most part less than a year with the colors, had an (Effective strength of 2700 men, of whom 300 were recruits; it was possible to jueserve until the end of the operations only 1G3. The 40th Battalion of Chasseurs, formed under the same conditions, did not arrive Ix^fore the capital of the island at all, and out of 700 men, only 120 returned to France.* There is one consideration, however, which should not be lost sight of in organizing an exjicdition : it is the necessity of not removing native soldiers entirely from their own coun- try. The idea of making the Annamites serve in the Soudan, or the Senegalese in Indo-China or Guiana, if it were ever *In B('nin, in 1890, the white troops lost 46 per 1000; the natives, only 19. Hygiene of the Soldier in the Tropics. 127 put in practice, would give results only intiuitely worse than those produced by the use of white troops in the same countries. Recall in this connection the susceiitibility of the blacks to cholera, the complete unfamiliarity of the Indo-(niinese races with yellow fever, etc., not to speak of the discourage- ment which would take possession of natives transplanted in a climate totally strange to them. The Creoles, like the blacks, could render us excellent service at their homes. This is a point which should not be disdained, especially at the time of an expedition. Since the law of the 1st of August, 189.5, relating to military service, Reunion can furnish every year a contingent of about 800 men. That is the worth of a battalion, and of a regiment for the three contingents of the active army. The Marine has it in hand to take 2400 men ready to be levied in Madagascar. The battalion of volunteers of Reunion was recruited under 'the worst possible conditions, and nevertheless has shown good powers of resistance: Out of an effective strength of 549 men, officers and Europeans not included, the proportion of sick or convalescents withdrawn wa« 28.-4 per cent, and the proportion of deaths did not exceed 3.09 per cent. This recent example augurs well for the services of the young Creoles of Reunion, once they are well instructed and organized. Doctor Th^ron has remarked that the nearer the con- script approached the white race in color — and with stronger reason the white Creole — the more cause there was for his exemption from service; the more traces of African blood there were in the conscript, the better were his chances of being declared physically good. From this it would appear 128 Hygiene of the Soldier in lite Tropics. that the effectives fuiuished by Keniiion should iueliide a very small pro[»c)iti()ii of white Creoles, and that the colored Creoles should be in great majority, calling by this name both the Creoles of the centers arid also those with little trace of white blood from the heights. The European element is an indispensable factor in the organization of the natives. It sustains the creole troops and fni-nishes on the l»attle-tield that old (/iKird which decides the victory. This reserve, few in numbers, ought to be of proved solidity, a veritable plialanx. seasoned to disease as well as to bullets; it ought to be c; III. Convoys and Siipplirs. The (piestion of convoys and supplies, which enters into the preparation of every well-planned exi)edition, has always received great attention from the chiefs of ex]»edition, espe- cially in the hot countries. It is not an easy thingvt(» \yvo- vide food and munitions for a column advancing into a coun- try, sometimes unknown, and wh(^re there are neither roads nor paths; it is still more ditticult to provide for the trans- l)ort of the sick, who must be taken to the rear. It is, tirst of all, necessary that the nialfriet sent from Fiance arrive at the base of operations at the i)roper time, that it be placed in the shelter of suitable store houses, and that it be forwarded to the troo])S on the march and to the detached i»osts all along the lint^ of operations. To peit'orni these numerous duties, it is necessary to have transport animals ar.d a uuuibei- of native coolies pro- j.ortionate to the etiective condtataut strength, taking into account the necessity which will often exist of having the packs of tlu^ soldiers carried by the auxiliaries. If the supplies can be forwarded by \v;itei ways, in place Hygiene of the Soldier in the Tropics. 129 of euioUing' oiilv the bt'aicris, it will be iiecessary to look out for boats, pirogues, aud oarsuien iu sutticieut uumber, accoid- ing to the quantity of stores to be transported and the length of the route. The principle is to never transform the soldier, espe- cially the European combatant, into a coolie. A heavy load should not be imposed upon the wliite troops in the Tropics, and all the skill of the general should be directed towards disposing a convoy in such a way that no fatigue for thi' combatants will result from carrying an excessive weight. The Bearers. — It is necessary to have a sufficient number of bearers: that is the difficulty of every colonial expedition, and it was on account of deficiency in this respect, during the Madagascar campaign, that use was made of troops for the unloading of maifrlrl, the construction of roads, and the transport of food. Besides, it is sufficient to see the care taken by the chiefs of expedition to collect armies of bearers to follow their col- umns of operation. They are necessary impedimenta: with out bearers, a colonial expedition is impossible. During the expedition to China, in ISOO, the English army of lO.OOO men had a convoy of 2500 aninmls, in charge of 200 conductoi's, assisted by ."'OO coolies, while our 3000 French troops had only 1000 bearers to transport all their maierieJ. A little later, in Cochin-China, we were able to organize a corps of 1800 natives charged with the convoys. In Abyssinia, in 18(17, the English had more than 0000 auxiliaries of this kind, commanded by Europeans. For their convoys on the expedition against the Ashan- tees, our neighbors made use not only of men, but also of the women (►f the A\'est Coast, long accustomed to this trade, which they carried on for the merchants of the littoral. Nev- ertheless, the English one day found themselves in a deli- 9— — 130 Hygiene of the Soldier in the Tropics. cate sitnatioii on account of a nionientaiy defection amou}; their auxiliarief*, and no one knows what would have hap- pened but for the energetic and intelligent initiative of the corjis conmunider: General AA'olseley immediately called into requisition the native soldiers of the West India Regiment, and for fifteen days confided to them the functions aban- doned by the negro deserters. The expedition suffered no delay, but only cost a little more, for the general rightly believed it to be his duty under such circumstances to pay liberally for the special services of the native soldiers. In Egypt, in 1885, the English collected 7000 Soudanese as bearers; and they i)laced under the orders of a major, to fill that office during the campaign in Zululand, 2000 natives, levied upon the frontiers of Natal. The Russians in their campaigns in Central Asia have likewise had recourse to immense convoys. In 1880, Skobe- leff had no less than 21,000 camels at his disposition. Let us now see what we have done of late years: In Upper Senegal, the first column of 1880, for an ettt^-t- ive force of 500 combatants, had no less than 50(1 native bearers. In Tong-King, the organization of the coips of coolies during the expedition w^as the constant care of our generals, and yet our men were very often much more buidencd tlian was suitable. General Bouet collected 500 bearers befor<' the march ujion Sontay; (Jeneral :Mill«»t. more than r.OOO. of whom 2000 accomi)anied the first brigade advancing towards liac- Ninh. Each grouj) of 50 bearers was commanded by a rai (Annamite corporal). Before advancing u])on Lang Son. General Byu\v dc risle likewise paid s])eciMl attention to the organization of a large convoy. Useful Pncautiniis.—M' tlie ;iut liorit ies ought first of all lli/yiene of (he Soldier in the Tropics. 131 to demand of the coolies !>uttieifectly denioustratcMl thai this role was quite other than has been dej)ict( d. The commandant of tlu' naval division of the Indian Ocean exjdaiued the measures to be taken, from the com- Hygiene of the Soldier in the Tropics. 133 mencenieiit of 1895, in case tlie road to Tanaiiarivo, by way of Majuuga, should be adopted. This route, which was preferred by Coh)nel de Beyli*^, was longer than that from Taraatave, but was intinitely better adai>ted to tlie march of an important column, and had, besides, a precious advantage: that of ])ermitting the utilization, for a good jjart of the way, of the great river Betsiboka, which, emptying into the sea before Majunga, is navigable for ships of light draught. In his report of the 30th (^f May, 18!)4, the commandant of the division asked for the naval iiKilfricI ap])ro]jriate to this navigation: 50 lighters, 12 tugs, and several gunboats. Alluding even to the military question, he recommended that the troops be sent in two installments: the first, of 2500 men (robust and seasoned, formed from the Foreign Legion and the infanterie de marine) to arrive in March-A])ril; the second, the main body, to arrive about the 15tli of May — that is to say, at the height of the dry season, a favorable time for the PX])edition. ^>o regulated, the troops of the ad- vance guard would have occupied, from April, the two banks of the river, in a location near the sea; they would have •driven off the enemy, thus assuring free navigation to the gun-boats and tugs. The main body, ascending the river with the flotilla, would have rapidly crossed the low regions of the island — that is to say, the hot lands and the marshes. It was the means of most sui'el}' avoiding, without too luucli loss, the fever, the most precious ally of the Hovas. In order to properly carry out this programme it was necessary to know thoroughly the character of the Betsiboka. Some time before the expedition, ^Iidshi])nmn Compagnou, of the Primauguet, passing himself off" as an agent of the min- ing comi)any of Suberbie, was sent npon a steamer of that company, and took bearings and soundings. 134 Hygiene of the Soldier in the "Tropics. In the interval, aided by some companies of infanterie de marine from Diego-Snarez and Rennion, Admiral Bienaim^ was snccessfnl in a militaiy occnpation of Tamatave, the lltli of December, 1894, and of Majnnjia, tlie KJth of Jan- uary, 1895. These two ojierations were accom]»lished with- out noise and without serious resistance, which led the com- mander-in-chief to say in his letter to the Minister, and with an accurate perception of the future: "It is known that no serious resistance is to be feared and that all efforts should be directed to the organization of the service and the move- ment of the convoys." Majunga once chosen as the place of disembarkment, an apparatus was installed upon the shore for distilling sea water, as soft water is rare upon the margins of that vast bay. Then the entrance channel was marked with buoys to warn all ships coming there for the first time of the difficul- ties of making land; finally, the ^lalagasies were recruited to serve as bearers or navvies — that is to say. as auxiliaries of the Army at the time of its taking the field. Admiral Bienaime had been careful to inform the Min- ister that the recruitment of the Malagasies would be very difficult and insufficient. In default of Chinese, always cludera suspects, he would have to resort to the blacks of the African coast. The lack of coolies imi>osed a great excess of burdens on the Marine; but, umler the impulsion of its chief, it -was able to accomplish i»rodigies in the unloading of the ships and transports in the rivei-. With the aid of a company of infan- terie de marine, iNIaroway was seized on the 2d of May, 1895, a new proof that the op<'rations could have been conducted by the river. ^ I\'. Saiiilari/ Scrrire. A sanitary organization i)re])ared for a continental war Hygiene of the Soldier in the Tropks. 135 cauuot be used in a colonial campaign without modification. In this connection, the Madagascar campaign is instructive. The theory of the field hospital is based on European war: it advances at the same time as the troops and a dis- tance determined beforehand; it can be installed in villages and houses reciuisitioned; quarters and beds are found there and also indispensable accessories, such as kitchens and laundries; to begin operations, it is only necessary to open the bottle-cases and paniers. These dispositions are not applicable in the colonies, where nothing is provided, as a rule. It is therefore neces- sary to take up all the questions relative to the organization of the health service: personnel, materiel, transport of the sick, locati(»n of the hospitals, and evacuation. PERSONNEL. The chief of the health service of the expeditionary corps should be of high rank, should have local experience, and should possess the absolute confidence of the com- mander-in-chief of the expedition. The surgeons should be chosen among those who have a knowledge of the country and experience in colonial expedi tions. They should be in great number. The regiments should have their complete medical effective: (» surgeons to the regiment, 2 to the battalion, and this number shouJd be increased by 2 as substitutes, mak- ing a total of 8. The sanitary organizations should likewise have their complete effective, increased one-third to fill unforeseen vacancies caused by the establishment of posts along the line of supplies. We have always been too parsimonious. In Dahomey, in 1892, the sanitary personnel was too small. For 1432 European and 2170 native combatants, we had only 18 snr- 13() Hygiene of the Soldier in the Tropics. geoiis: 9 with tbe column, 5 in the iiosjutals of Porto-Novo and Kotonou, 4 on the Myflio and the convoy ships. This number was too small; with the column, and in the hos- pitals especially, it should have been doubled. The deft ciency would have been more noticeabh^ if the expedition had not been so successful. In Madagascar, in 1805, the number of sur^jeons was much too small. The trooi)S were iirovided with '1 surgeons to a battalion, or 24 for the European regiments. The sani- tary organizations were supplied with a variable number of surgeons and }>harmacists, according to their imi>ortance. The sanitarium was sufficiently supi)lied, but the hospital of evacuation and the field hos]>itals were lacking in personnel. If we had adopted Ihe ](ro])ortion of surgeons sent to the Gold Coast by the English in IST:^, there would have been more than :{()() sent to ^Madagascar. It was thought suffi- cient to send 80 for the 15,0(10 to 16,000 combatants, to whicli number must be added 7000 auxiliaries. The i)roportion was almost identical with that in Dahomey; it was very insuflicient. The pharnuicists are useful in the sanitary organiza- tions and should not be forgotten. There should be a sufficient number of veterinarians to give the necessary care to the animals of the convoy; 20 were sent to Madagascar and they were efficient in caring for the 0000 mules. It was anxiously asked if the mules could live in Madagasrar; they did very well, because they were admirably cared for. The nurses should be numerous, als). In Dahomey, out- side of the regimental nurses and auxiliaries, there were only 20 Europeans and (J natives. In :Madagascar a greater num- ber had been provided; 1 nurse had been sent for 5 hospital beds, and as the number of beds for the various organiza- tions was ;'.000, the total number of nurses was 000. Hygiene of (lie Soldier in the Tropics. 137 Nevertheless they were iiisiilti<-ieiit, since nurses fall sick as well as soldiers. Three months after the arrival, it was not rare to find a sanitary organization practically un- provided with nurses. In Auoust, at the hospital of Anka- hoka, there were only 4 well nurses for 1000 sick; at Suber- bieville, there were only ('► nurses for 000 sick. It must also be said that in the French Army we have no regular corps of nurses, as in the German, where special corps of them exist. Our nurses are scarcely initiated in hospital life before they return home. The colonial army, when it is formed, should possess professional nurses, like the Marine. This is not only necessary, it is indispensable. MATERIEL. In a colonial expedition, such an incumbrance as the complicated equipage which follows an army corps in Eu- rope is not to be thought of: surgical and administrative wagons, wagons of supply and reserve, tents and barracks. It is necessary, however, to transport dressing mate- rials, medicines, food for the sick, and shelters or the mate- rials to construct them; it will also be necessary to provide for the transport of the sick. The expeditionary corps of Madagascar had 4 cam- paign hospitals, of 250 beds each ; 1 hospital of evacuation, of 500 beds; 2 flying field hospitals and 18 field hospital infirmaries. There was also a sanitarium of 500 beds. The field hospitals were provided with a considerable number of dressing materials, hand-litters, liorse-litters, and cacolets. The materiel of the unit of the sanitary organizations — the battalion service^included 2 Lefebvre wagons; 11 pack- mules; 10 paniers of supplies, 2 medical, 2 operating, 2 of dressings and quinine; 10 field-hospital bags; 12 litters, with hoods; and 1 conical tent. 138 Hygiene of the Soldier in the Tropics. Each body was to be followed in its opeiatious bv a field hospital comprising 12 Lefebvie wagons, 8 pack-mules, 10 mules for cacolets, 2 mules for litters, and a suitable number of coolies. A road had been supposed to exist; the regulation wagons for a tield hospital had been replaced by the Le- febre; the horse-litters and cacolets reserved fn an expedition should be studied and regulated in ad- vance, and in a special manner for each expedition. To attain this end, the special nature of the expedition, its diffi- culties, and its duration must be known. Doctor Fruitet is of the ojunion that the regimental sup- plies of Europe can be utilized with certain modifications: 1. Suppress the regimental medical carriage. 2. Utilize only the collection of four j)aniers. ?>. Suppress the two reserve paniers of dressings and replace them by medicine paniers. The colonial and post store-houses should contain mobil- ization materiel; each of our colonies should be i)royided with a materiel suited to its needs. If a great expedition were about to take place, it would only be necessary to call attention, in France, to the models and systems already in use in the colony, in order to prepare, in suitable proportions, the medical materiel, needed by the columns. 140 Hygiene of the Soldier in the Tropics. MEANS OF TRANSPORT FOR THE SICK. The mode of transport to adopt for the sick and wounded has its importance. There can be no question here of the luxurious conveyances and sanitary trains which usually accompany our Eurojtean armies. In the hot countries, the sick can best be conveyed to the hospitals in boats or junks or by ti-ansportation on the backs of animals or upon litters. Boats are used only when the distance is long. In Tong- King, use is made of junks so arranged as to shelter the sick and wounded from the sun and lain. In Madagascar, there were lighters and steamers with which to descend the Betsi- boka; they would have been more suitable if there had been a roof and curtains of blue muslin to prevent reverberation. Transport on the backs of animals is not to be recom- mended. In France, in mountain warfare, mules and horses furnished with racoJeis are used. This mode of transport is painful for tlie wounded, and is (^onseipiently not very j)rac- tical; it can be used only for a certain class of sick, upon suital)le roads, and for short journeys. It constitutes a ver- itable torture, under the sun, in countries which have no roads. In the colonial wars, oxen, camels, and even elephants, have been employed; the objection to these is even more serious. In the Madagascar campaign, it was thought for a moment of using zebus, the native humjied oxen. These ani- mals aie very numerous on the island; luit it would have been necessary to train them to carry the i)ack, and the tiain- ing would have taken several months of patient work. At Majunga, some of these zebus were trained to i>ull wagons, and even this oi)eration was not without danger. Beasts of burden < an be jjrojterly used only in the trans jioitation of rations and iiKilh-id : other means must be found for the sick. * Hygiene of the Soldier in the Tropics. 141 The transport on the baric of man is the most practical and coiiifoitable for sufferiuo- men. It is performed with the aid of litters, haud-barrows, chairs, palanquins constructed in the fashion of the country, etc., constituting- a very light and easily managed ruaforiel. The regulation war litter is not very practical for slop- ing ground; moreover, the handles are too short and the bearers, when they have to make a rather long journey, are obliged to add two handles of bamboo in order to obtain a longer lever-arm. A good model is the palan(iuin used in Tong-King. In principle it is composed of a net suspended by its two extrem- ities from a long bamboo; the natives placed at the ends carry it upon their shoulders; a sort of carapace, or covering, placed above the bamboo, protects the recumbent man from inclemencies. The Dutch have improved on the palanipiin and have adopted what they call the Chinese hand-barrow. It is made of a piece of sail-canvas L* meters long, at the end of which are iron rods intended to keep the canvas stretched. Each rod has a ring at the center. A large bamboo 4 to 5 meters long is passed through the two rings, which are fastened and cannot approach each other. At each extremity of the han die is placed a piece of hollowed band^oo, supporting a mat- ting roof to shelter the wounded. In Dahomey, litters and hammocks were the principal modes of transport for the wounded. The hammock for two bearers, the one most employed, was composed of a bamboo of sufficient length, about 2.5 meters, and a material of cotton or canvas in the form of a ship hammock; the natives placed the extremities of the staffs u{»on their heads, and could thus complete a course of G kilonu'ters an hour. The hammock for four bearers, more comfortable for the sick, was a sort of bamboo frame, provided with cotton cloth. 142 H i/(/ieiie of the Soldier in the Tropics. Ill Madagascar, tlie mode of traus])oit cominoiily em- ploy is the filanzane. This is a sort of palaiKinin carried by four men. Tlie a])i)aratus is light and easily managed. It is formed by wooden staves, eaeli '^.'^> meters in length, kept apart to a distance of only -U centimeters by two cross-bars of iron. An iron frame, having a horizontal part for the seat and a cnrved part for the baclv, is fixed upon uprights of wood. The bottom of the frame is made of cloth; a little movable ])lank sus]>ended by cords sup]iorts the feet. The filanzane is a very practical apjiaratus and is easily procured in .Madagascar. It was used for carrying the sick to the sanitarium of Nossi-Comba. The Jjourjaxes or Mala- gasy bearers make great use of this system; they place the extremities of the wooden bars on their shoulders and almost always take a lengthened trot; they relieve each other without stopping, changing shoulders without diffi- <'ulty, and make 4 kilometers an hour in a mountainous country. The model in use by the .Malagasies would be suitable as it is for carrying a convalescent. For the seriously sick and severely wounded, it would answer with a few very simple modifications: a greater se])aration of the staves, the addi- tion of a hood to give ])rotection from the sun or the rain, and the ])]acing of a l»amboo center to sujiport the thighs and permit the wounded to lie down, witli the lowei- limbs well supported uj)on this inclined jilane. Whatevei- the system adojded. it should not he foi-gor- ten to provide a great many of the transport ai)paiatus. Con- sidering the numbei- of sick that may have to be jtrovided for, we believe a geneial-in-chief onght to make suie of hav- ing a littei- for every t<'n men. at least, to which should he attached two or four bearers. In Dahomey, in spite of all the jiret aiitions taken, it was Hygiene of the Soldier in the Tropics. 143 neeessniy to hastily inannfactiiie litters of fortniie with branches of trees and the canvas of tents. An armv of 5000 men, going under tire, ought to have 2.)M) coolies and 500 litters for the special servi<-e of sanitaiy convoy. HOSPITALIZATION OF THE SICK AND WOUNDED. Without counting the field hospitals and infirmaries where the sick and wounded receive first aid, but where they cannot remain for a long time, there is a choice between three great systems of hospitalization: the campaign hospi- tals, the hosi)ital-ships, and the sanitaria. They answer to different needs, and should lend a mutual cooperation; in place of a regrettable antagonism, it is indispensable that there be complete harmony in the services. 1. Campaign Hospitals. Whenever the operations are in the interior, it is nec- essary to establish campaign hospitals. The field hospital of the first line advances with the troo])s, and sometimes, when the distance is considerable, it is useful to connect it. by a field hospital of the second line, with the infirmary of the garrison, or, better still, with the campaign hospital which is to receive the seriously sick and wounded. There should be no waiting for these hospitals to be made ready, and in conse(iuence the necessary elements to establish them must be ])roAided in advance. Hutting might answer, in spite of the many com])laints which have been made about the use of huts in colonial expeditions. The hut is a defective lodging, often bad. If necessary to erect huts, they should always be built on the double-shell principle. To compensate for the slight thickness of the walls, they should be doub]«Ml: double walls, double ceiling, double floor, inclosing between their two surfaces a cushion of isolated air. 14i lli/f/ieiie of the Soldier in the I'ropics. There are several models in our couutry. By ohoosiug one possessing the desirable elements, bearing in mind the principle jnst laid down, it would be easy to erect a kind suitable for this purpose. It might be possible to utilize certain of those light con- structions, nmde for our temperate country, and too sensible to cosmical action by reason of their delicate texture, for use in the Tropics. On that account they might be placed under great sheds, whose roofs of boards or straw would shelter them from the rain, the sun, and the humidity. These roofs should project all around the walls of the hut, thus making a circular gallery, which could be inclosed, putting numerous doors and windows in the wall. This would also make a habitation with double walls, ra]»idly ]»rei»ared, at little expense, and with all the advantages. Tents are sometimes employed, but they are still more inconvenient. The shelter-tent, opn three sides and arranged so as to form a horizontal roof and a posterior wall, neither protects from reverberation nor from the wind. E^qually objectionable are all the closed tents, conical or others, whose walls prevent proper ventilation. A new condition is imposed for colonial campaigns. The most simple model to be recommended is one appr(»ach- ing the tent used upiui the deck of ships. It consists of a large tari)aulin, stretched upon four j)ickets, with side cur- tains capable of being raised or lowert^d at will. The uia- terial could be made water-i)roof on the exterior and coloi'ed in green or blue. The ideal would be to have it double. It could be sjninkled in the h(»t liours of the day to cool it ;ind <-ould be carefully covered with foliage. The Madagascar campaign showed the defectiveness of all these systems. The tents, while easy to set up, were un- inhabitable; th(» temperature under the great tent of the Hygieite of the Soldier in the Tropics. 145 liospital at Suburbieville rose to 38 degrees at the bedside of the sifk and to 42 degrees between the two canvases. The hnts adopted were of the Werhlin-Espitalier system; the walls were made of a trellis of iron wire and cocoa hair; the roof of canvas. The Malagasy constructions, of raphia, well raised above the ground, with a double roof and wall and a gallery, were the most satisfactory hygienically; they were to be ] (referred to all the others. The greatest trouble with impiovised hospitals is to jtiovidc all the accessories. The hosi»ital at Majunga was organized after a time; it consisted of board huts, Espitalier huts, and tents of all kinds; the sick were passably quartered, but the kitchen was in the open air, the water failed, the sink-screens left much to be desired, and disinfection was impossible. The hospitals were scarcely established before they were overflowing; each was intended to receive 250 men, and they soon had to shelter 000 and more. At Ankaboka, where the hospital of evacuation was located, there was an unheard-of crowding of sick. Coolies mixed with European soldiers were crowded there. It was useless to give the natives beds which they would not use; huts with a sort of camp bed and bedding would have sufficed for them; there they would have found more comfort and infection would have been less great. Even in Europe, disease has always been the great enemy of armies in campaign. In colonial wars this enemy is still more formidable. That is why too great pains can- not be taken to provide the means capable of insuring the proper care of the sick. This is an ajtproved doctrine in ordinary times; yet everybody seems to be ignorant of it when an expedition is about to be undertaken. 10 14G IJyiiiene of the Soldier in. tlte Tropics. 2. Hospital-Ships. As soon as possible the sick slioiild be withdrawn from the usually defective campaign hospitals and placed upon hospital-ships, held as near as possible to the base of operations. For a long time and with reason it lias l)een the idea to use ships for (luarteiing and caring for the sick in the expe- ditions to the paludal countries of the ton-id zone. In 1S41, at the time of the Nossi-B^ ex])edition. the mor- tality diminished greatly from the time the soldiers of the expeditionary corps were required to go aboard the ships every evening. Observations of the same kind were made in Madagascar duiing the campaign of 1SS4-1SS5; the fever never left the men (puutercd (Ui land; a sojourn aboard could alone relieve them of it. This conviction undoubtedly existed in the mind of the superior authority when it was decided, at the beginning of the expedition of 1805, to send to Majunga the great hospital- transitort Shainrorl-. the dii-cction of which was confided to Doctor Hurot, chief surgeon of Marine. IMaring in the bay of Hombetoke an admirably it^gu latcd liosjiital slii]i, with all tlu^ means for assuring the wc^ll- bcing of th(^ sick, was not one of the least services rendered by the ^larine to the (^x]»eeditionai'y cor])s. And it is one of till' measures which has been received with most favoi-, since it answered the unaniuious pi-ayer: Prolecl our snldicrs from llic fcrrr. It can be attirnied that many lives would have been sjiared if the troojis, fioiu their airi\al. while awniting the ])rej:arat ions and the march to the front, had been ([uartered u])on the watei' and hospitalized ujion the shij»s. It is indis- jK'iisable, in undertaking llie conijuest of a f<'Ver counti-y wheic nothing has been pn'pared. to have Moating barracks lljlijiciu' of the Soldier in flic Tropics. 147 for (iiiarteriiij' tlu^ men, at leas^t at night, and hosjiital-sliips to care for tlir sick. 11'/;^// a IIospif<(l-Sliip Ouijht to He. — It is especially in col(»nial cx])eoop, transformed the deck into a supplemen- tary broadside. Movable ])lanking was put in for renewing tht^ air, ])latforms for jiromenading in the 0])en air, beds for certain classes of wounds, ice-houses, and improved ventilat- ing apparatus.* ♦During the last campaign against the Ashantees, in 1896-97. the English fitted up the CUn-onidinhl in a remarkable manner. Hav- ing chartered this superb steamer of 4800 tons from the Peninsular and Oriental Company, they transformed it into a luxurious hospital, furnished most suitably: a day salon, protected from the sun by a double roof and movable Venetian blinds, an isolation ward, an operating-room, a steam apparatus for ventilation between decks, punkas and fans moved by steam, electric lights, improved laundry, disinfection and distillation apparatus, machines for making seltzer- water and ice, cold-storage room for preserving meat, milk, and 148 Htif/ieiie of the Soldier in the Tropics. The crew lived forwai'd and was -t^epa rated from the sick, never conimnnicatinort the humid heat without deterio- rating, were disinfected by the sublimate with the aid of a large atomizer. Twice a week the decks of the hospital were gone over with i>otash and washed with chloride of zinc; the same for the walls and for the ii'on and wood portions of the beds. At each departure, the mattress and beddini; were passed through the disinfecting stove. Whenever there was a death in a room, the jilace was hermetically sealed and fumigated with sulphur for twenty-four hours; an atomizer with the sublimate was then used in all parts of the room, which was repainted, while the bedding was disinfected by va])or under pressure. The laundry, working regularly, i>ermitted the cleaning of all the soiled linen. The hygienic buckets always con- tained disinfectants. 152 Jlijgieite of the Soldier in the Tropics. The sick were well iioiuislied and the meals as varied as possible. The ration of the siek, made ii]) aecordiug to medical prescriptions, had as its base the ration aboard: bread, meat, beans, coffee, and sngar; in addition, there were commodities specially embarked for the sick, and finally, there was bought on the spot, to replace the commodities embarked, any thing which could improve the mess. The general recaititulation of the foods dispensed in the hospital of the SJiainrocl- was scruimiously nuide. The calcu- lations were nuide for each commodity separately. The food on the Shamrocl\ in regard to variety and prep- aration, was equal to that of a great hospital in France, and yet, taking everything into account, each jiatient was fed at a rate of 1 fr. 37 iter day. It would be interesting to consider the cost price of the ration for the ])atient in a camjiaign hosi)ital. and establish the comjiarison. The soldiers all wanted to go to the Shanirocl\ and some of them considered themselves saved when they saw their names on the removal list. They would no more be put to bed on the ground, in the dust, and they kn(^w they would find what was necessary. Results of the Campaign. — The results of the campaign are easy to ai)preciate. From the day of the dii)arture from Toulon, the I'Tth of January, 3805, to the day of return, the 15th of September, of the same year, in eight months and fifteen days, there were <;.H deaths on board. From this number it is necessary to deduct 3, pertaining to the crew or to sailors embarked for ^subsistence. The ShajnrorJi- having really commenced its service as a hospital shi]) only in iho month of March, thi^e rc^main (50 deaths for a period of six months, among the men received If i/(/lcii(' of llie Soldier in llie Tropics. 153 iis patients: this j^ives 10 deaths jier month, or 1 every three days. This proportion is not comparable to that of the same epocli in the campaign hospitals, at ^Nlajunga and especially at Aukaboka; it approaches, moreover, though it is inferior to, that usually observed in the hospitals of Toulon and Saint-Mandrier. In the 60 are included not only the deaths which took place at Majunga while the shij) was stationed there, but also those W'hich took place during the return voyage, and which considerably increase the proportion. The sanitary condition of the Shamrock may be looked at from two different standpoints. In the five months from the loth of March to the 15th of August, there were 20 deaths; in one month, from the 15th of August to the 15th of Sep- tember, there were 40. The projiortion at departure from Majunga had been 1.5 per cent; the return voyage raised it to 3 per cent. During the entire period of six months the Shamroch received 2000 sick; there was a daily average of 300, giving 4(),000 hospital days. Relatively, the total number of (>0 deaths for such a large number of sick, and under such exceptional circum- stances, is of a nature to inspire reflection. In August, the sanitary situation had become very crit ical in Madagascar, and, if the transports were put to the sad necessity of throwi»g many cadavers into the sea, it was chiefly because the sick were in a state of intense cachexy when they were embarked. It is to be regretted that the repatriation did not commence sooner. After w'hat took place on the unhealthy banks of the Betsiboka, there is no doubt but that the campaign hospitals would have been advantageously replaced by ships, hulks, or lighters, anchored at diff"erent points of the river. The 154 Ili/giciic of the Soldier in flic Tropics. luilltai-y isni-geons were devoted; they aceoiuplishi d their duty with the .ureatest intelligence, but they could not shelter their sick from the efiiuvia of the marshes. In the course of the campaign, everybody regretted not having had sev- eral floating hospitals: some stationary, to receive all the sick of the expeditionary corps; others mobile, to conduct them to the sanitaria or to France. 3. Soniforid. In colonial campaigns, there has been a thought of using certain localities, favored as to situation and altitude, in order to send there, upon their departure from tiie hospitals, the sick, or rather the convalescents, in the iiope that, after a few weeks of rep»)se, they might be able to i-ejoin the column. It is principally in Madagascar that this has been tried. In 1884, places of convalescence had been sought on thi^ East Coast. The results were bad, none of the places chosen having fnltilled the conditions of a veritable sanitarium. The island of Reunion, thirty hours from Tamatave, was tried for the purpose, and then al;andoint of disembarkation, in a situation as agreeable as healthy. There, those sent from the other hos- pitals could have lived, and only the convalescents, the anjemics, would have been sent to the heights. At Nossi-Comba the nights were cool and damp; in July it was 26 to 28 degrees during the day and 16 to 18 degrees during the night. Beginning at 6 o'clock in the evening, 168 Jli/f/iene of flie Soldier in the Tropics. there AViis a mist, and in tlie niorninji, at reveille, eaerytliinj; was covered with dew. The attacks of tev(^r there weie less frecpient than at Majnnga; but, as is the rule under the circumstances, diar- rhteas were more numerous; rheunuitism and tuberculosis patients did not do well there. The hope of sending the men back to the column after treatment was delusive. In reality, Nossi-Comba was restricted to use as a station between INIadagascar and the ships charged with repatriation. It was no longer ana^mics more or less worn out by the hot climate, who came there in search of health, but men heavily depressed by attacks of a formidable paludism and whom it was important to shelter as quickly as ]»ossible fiom danger ]»y sending them back to France. If the mountainous climates in the tro])ica] regi(U!s have an incontestible advantage as a means of itreservation from paludal diseases, they ])resent dangers which should be well known when it is pi-o])osed to establish a sanitarium, the object of which, in a hot country, is very different from what one is accustomed to believe it in Europe. In 1S1>5, in Japan, at Nagasaki, Admiral de lieaumont. counnanding the nuA'al division of the Extreme-Orient, had tlic hapjiy idea of i-euTiiig. upon ilu' heights which dominate the magniliceut roadstead, a •■onntry-house belonging to a i-eligious congregation, in oidcr to send th(M-e for convalet*- ccncc. in Se]iteniber and October, a cerlaic number of sailors of the naval division, who had been attacked by cholera and the paludal feveis of Woosuiig. h was auiced that, according to i-nsrei-. one of the snigeoiis ol tile shii»s |ires- ent in the i-oadstead should -o twice a week to Tomaclii to visit the convalescents. .\n nion ir/iosc rondiHon (Icnunidfd virdiral rnrr irns to In' sent to the sanitarium. Tlie <'stabljsh- nieiii was to furnish e\c<'l!(MiI food. Ilijijkiw, of Ike Soldier in. the Tropics. 159 All the pallidal ])atieiits sent niidcn- these coiuliticjiis to Toiiiachi recoveiea lapidlv and were able to rejoin their ships completely cured. On the contrary, there were relapses among the former diarrhoea i)atients, which neces&itat(^d their repatriation. Diarrhoea, dysentery, and hepatitis do not disai)]>ear in the heights of the tropical countries; far from it, they reap- pear. The dampness and the coolness of the nights provoke their reappearance, and also that of paludal attacks in the case of pers(ms who commit the slightest imprudence. The tendency to diarrhoea is so marked that several Eng- lish surgeons have written that the diarrluea of the moun- tains is only a transformation of the malaria, which in infe- rior regions produces the attack of fever. It is sure, how ever, that this diarrhoea of the heights (piickly jtroduces an aua?mic condition; it has a cacluM-tical influence like scurvy. It is ameliorated neither by uu'dicine nor diet; repatria- tion alone, the sea-voyage, can restore the blood of the sick to its norniMl condition, if there is yet time. So, if tli<^ altitudes prevent, they do not cure; the sani- taria of hot eountrit^s should never be hos])itals, but sim]>ly places of waiting for the convalescents to be repatriated: in the nautical habitation, the hos]»ital-shii» sjiecially prei)ared, there is health for the ])aludal patients whose cure is still possible. Experience has always and everywhere demonstrated the excellence of this system, and in Madagascar, before the expedition, everybody was of this ojiinion. Th(^ o])erations once begun, it was too late; the utilization of the enormous materiel sent from France obti-uded itself. Contrary to current ideas and to the interpretations which have been given to the role of a sanitarium, the fig- ures furnished by the hospital of Tamatave confirm what wo have just said. ]60 Hi/f/iciic of the iSoldicr in llic Tropics. From the 12tli of December, 1>;1>4. the day of the arrival of the troops, to the 20th of February, 189(1, the day of the raising; of tlie state of sieatriated fiom .Madagascar and by learning the nund)er of deaths which had taken place en rmile. The emoliiui was (]uickly calmed when ii was learn< d what had taken place in tlie island its<'If. n ifl/inii' of the iSdIdIrr in llic Tiopica. 163 While UUO men (lied in the hospitals on land, an average of 4 per day, the deaths on the transports averaged only 2 per day. With an ecpial number of sick in the same condition, the deaths on the voyage were only half as great, and those who arrived in Fiance had many more chances of recovery, for the sn])reme hoite of the sick soldier was to see again his native land. If the repatriation had begun in \\)\\\, the men would not have arrived at the degree of anipmia which they pre- sented in the following months. Those re]»atriated on the Shamrock came partly from the hospital of Ankaboka; they were in a lamentable state when they embarked: their faces were pale and swollen, their intelligence extinguished, their limbs half paralyzed. On the evening of the day of their arrival, several died suddenly. Very evidently it was not the embarkation which killed them, but cachexy. Logical conclusion: end)arked sooner, they would not have died. Kepatriation was then indicated; it should have been speedily ordered and surrounded by certain sui)iilementary guaranties. The sanitaria, which could not cui-e, would have been able to keep the seriously sick and iuei)are the others for the journey; that is to say, clean them, clothe them, cheer them up, and S(^nd them aboard only when in a condition to suiijjort the voyage. The isolation ilfpol at Majungji should have furnished articles of clothing to (^ach soldier about to be i-epatriated; issues of soa]) ;nid tobacco should have been made to each man, either from the subsistence supplies, or from the gifts of the patriotic aid societies. This was only ]iartially done. Thanks to the societies, wlntse aid has been so useful, the soldiers were at least provided with warm clothing. The dangerous jdiase of repatriation at that time was 164 Hygiene of the Soldier in the Tropics. the ciossiug of the Red Sea, as is almost always the case, cousideriug the situation of our colonies. It is, above all, a question of season: when the sun is highest — in September, for example — th«^ voyage is the most to be feared. In the hottest seasons, it is chiefly when one lands during the out- ward voyage that one suffers most. The frequent breeze from the north often makes the return voyage easier to bear. With ships of great speed, at least 15 knots, the progress of the vessel facilitates the aeration of the inhabited quarters. They should therefore be given the preference and stops at Djibouti and Aden should b«^ avoided, as they are more dis- tressing than the voyage itself.* Variations of temperature aie not less to be feared. On entering the Red Sea in summer, the thermometer suddenly jumps from 20 to 35 and 40 degrees, where it remains during the crossing, and then descends again to about 20 degrees on leaving the canal. Advanced cachectics are inadeipiate to the gymnastics imposed by this temperature on their lungs and skin. On the whole, in bad conditions of sojourn, especially when confronted by paludism, repatriation, cost what it may, is the only rational method of treatment, as M. L. Colin has said. If the exj)editionary corps in Madagascar had contin ued to remain in the valley of the Betsiboka, if it had not been decided a little later to repatriate, the army would have disappeared and the disaster would perhaps have surpassed that of San Domingo. § V. rfi/(/i('iiir Condiicl of Operations. Let us suppose that everything is prepared for an expe- *In motion, there is always a little breeze; at anchor, there is none. Hospital-trans])orts should be very fast in order to cross the dangerous zone as rapidly as possible, and they should have suftl- cient supplios to make it unnecessary to stop at intermediate ports. llyyiene of the Soldier in the Tropics. 165 dition and that the campaign begins; we are going to fol- low the soldier and give some more advice. Indeed, we must still examine the measures relative to the concentration of the troops at the base of operations, the march to the front, encamping, and hygiene. CONCENTRATION. After having chosen his troops, the chief will take the necessai-}' steps to concentrate them at a point whence they can be put in march. This concentration, and the whole campaign as well, should be made in the favorable season— that is, the dry sea- son and also the cool season. The operations should take place from October to April jji in Tong-King; from November to February in Cochin-China; ' from October to March in Senegal. At Benin, on the con- trary, it is necessary to act in the season of the high waters, from August to October, because the herbaceous vegetation will then have disappeared and this disappearance will per- mit of movement, while the state of the rivers will allow an easy access to the gun-boats. It would be a great error to order an expedition at the moment when an epidemic has just broken out in the ter- ritory the troops would have to cross. The epidemic would find in the march of the columns a ready means of diffusion, and would not fail to levy a heavy mortuary tribute on the « effectives. T During the period of concentration, care should be taken to avoid fatiguing the troops excessively, and especially to avoid marches which would exhaust them prematurely and result only in the inconvenience of a loss of much time. The sea or the rivers, those roads which march, should be utilized. The rapidity with which the tians]»oit and concentration of 1C6 Hi/fjieiic of the Soldier in the Tropics. tlu- units at tlu' initial point is made, whethei' by despatch- boats, ship's boats, and tugs, or by siiui)h^ junks and lif2;htei-s, >\'ill be a condition of success. It was a to(> sh)\\ conccMitration and a (h'fectixc organi- zation which set ni to have produced the bad sanitary results ol the campaign of Madagascar. While the iiuiterivl followc-d tlie water-way, all the troops marched j)ainfully by laud. It took tluMu thiee months to reach Suberbieville, where they could have been trans|n)rted in titteen days, if all the disi»os- able means had been employed. The fortitied posts of the Hovas were echeloned along the river and accessible by tin- water-way. The Gabes and the Jlo'eni, used by the commander in-chief of the naval division, Admiral Bienaim^, to recoa- noiter the river, would have been able to occupy Marohogo, Mevarana, and Maroway. The troops could have been trans ported by boat to within 25 kilometers of Suberbieville, and thus sjjared a march of 2(;() kilometers across the marshes. The concentration of men and nidtfriel could have been made at Suberbieville; it was possible to push on as far as Andriba without making a road, and, after a second concenti-ation. the column could have started, as it did, for Tananarive). THE MARCH TO THE FRONT. There is no doubt as to the result of fatigue imposed on soldiers camj)aigning in a jironounced ])alndal country Wkv Sent-gal, the Soudan, or .Madagascai'. It nia\ be said that each step of our columns towards I he center of the lUack Continent or towards the capital of rKmyrne has been marked by a d<'ad body. The jirincipal object of a corps commamler, then, will be to husband the strength of his trooi)s. The marches should be made dui-ing the least hot poitions of the ever, should ahvays be woni, as the heat of the sun on the unsheltered skin, like coolness, is always to be feared. The poor mardu-rs, placed at the head, will regulate the march and prevent a too rapid pace. The canteens should be tilled with coffee and water, with tea, or some acid drink. Stopjiing to drink or to draw water from the ponds encountered should be absolutely prohibited. In case of rain, water may be caught in the water-proof stretched over the arms; this will also serve to protect the soldier. Upon halting, it would be better to keep the men in the sun for a time than to place them immediately in the shade: the difference in temperature might be enough to chill them. For the same reason, even more here than on the march, the men should be ])0sitively forbidden to completely uncover themselves. It would also be very imprudent to permit the men to lie on the ground in the sun. The reverberation and action lof the heat reflected from a burning soil are the more to be fear-ed the nearer the man's head is to the ground. This is an observation made by all soldiers since (lenei-al Bugeaud: in campaign in the hot countries, a man lying- down will be more exjiosed to sun-stroke than a man on his knees; the latter, than a man standing; and this last, than a man on horseback, whose face is 2.4 meters from the ground. During a fight, this data may be im])ortant for the shar])- shooters, who are often j)laced in these different ]>ositions. If, in s]»ite of all these ]>recauti and face slioiikl hv bathed with cold water, his limbs should be stimulated by fiictiou, aud as soon as consciousness begins to return, he should be forced to drink in small draughts. In case respiration should be suspended, artificial respi- ration will be resorted to by raising both arms of the patient above his head simultaneously and then lowering them along the body, about twenty times a minute; or, better still, by making rhythmical tractions of the tongue. CAMPING. ]^o one is ignorant of the danger run by armies obliged to camp on unhealthful ground. During the occupation of Rome, the soldiers changing garrison were not lodged under tents upon their arrival at the halting-places; they were in- stalled for the night in the granges, farms, sheds, and in all disposable places. This is preferable hygienically to any encampment whatever. In fact, when an army traverses a fever country, if centers of population exist, it ought to be quartered upon the inhabitants and established in the houses with a view to avoiding a night either in bivouac or under a tent, w-hich offers only an insufficient shelter from the ground and the mists. If there are no centers of habitation, ingenuity should be taxed to create shelters for the night. In Algeria, our soldiers are accustomed to using the tent. This method of camping is so common, in fact, that each locality should have a camping-place for passing troops; wiien exceptional climatic conditions require, requisition is made for cantonments. It should be known that in our tropical colonies the con- ditions are very different from those of Algeria, and that methods praised for the one j^lace are not practical in the other. 170 Ihjyiene of lire kSoidier in (lie Tropica. If necessary to camp, the best .system of tent should be used, improved, as far as possibh^ witli branches and toliage. The grtmnd on whicli the camp is to be h>cated should never be dug up, but only cleaned and prepared by fire. This will be the best way of driving away insects, destroying the brushwood, and calcining the ground, rendered thus impermeable. As water is necessary for cleanliness and alimentation, the camp may prudently be established in proximity to a water-course, to the windward of marshes, and u])on a relief of the terrain, if not upon an elevated i)lace. Without removing too much earth, trenches will be traced in the direction of the greatest slopes; they will collect the rain-water and i)revent the ground occupied fi-om l)ecom- ing wet. Kitchens, washing-phues, corrals, and native camps will be phiced to windward of the camp for Europeans. Filth, (lehris of the kitchen or abattoirs, litter, etc., will be incin ei-ated daily. It is impiacticable in the temporary camps to use the movable tinettes so happily employed in cantcmments in Tong- King, Dahomey, and Madagascar, to jtrevent infection and the contamination of drinking-watci'. Arbois and screens will then be erected in confoi-mity with the ministerial th'- cision of Atigust 22, lS,s!>. The precautions there enjoined ai-e the metre im])ortant because in a march to the front all the tr()oj)S will be succeeded ujion the same ground. A failui-e to (ibser\(' the dispositions so wisely pivscribed would risk infect iiig the camping-]»laces. especially if they are occupied for any considerable length of time. Whenever the eiu ampment is to be of some duration, all the effects and bedding will be taken out and aired. In the absence of a camj) bed, one can be made upon the ground by the aid of stiaw or hei'bs covered with t lie wat<'i' proof. Hytjiene of the Soldier in the Tropics. 171 Tlu' sick will always be installed in the nn)st fa\(>rable places and sent to the rear as soon as possible by the means ])rovided for that pnr[>ose and according- to the rnles adoi)ted. HYGIENIC PRESCRIPTIONS. Everything which increases strength of resistance, in- clnding excellent quarters, good food, well-adapted clothing and ecpiipment, abstention from all exaggerated fatigue and fi-om all ovcMwork, constitute, and always will constitute, the best protection for troops in campaign. There are, however, other means to e^mploy in order to prevent certain endemic and epidemic diseases. Hygiene prevents paludism, but it is not a useless measure to have recourse to therapeutics also, and the nuunent seems to have arrived for saying a word about the cpiinine preventive. There would be temerity in affirming that (piinine em- ployed preventively annihilates absolutely the effects of malaria; but it seems certain that it greatly diminishes the severity of serious forms and that it makes the prognosis of the disease less difficult. In a general way, it considerably lessens the effects of paludism. Its value as a preventive rests to-day on a number of facts sufficiently great and posi- tive. No testimony seriously attributes to it a danger or real inconvenience. In fact, it has never been observed that men attacked by fever in spite of the (luinine administered pre- ventively have ever become refractory to the medicine when tilt' explicit signs api>eared. The results of experience in the preventive administra- tion of (piinine may be thus summarized: 1. Diminution in the number of accesses, which reappear only on the seventh, fourteenth, and twenty-first days. 2. Mildness of the at- 172 Hygiene of the Soldier in the Tropics. tacks affecting a legiilar tvpe. 8. Rareness of pernicious attacks, of bilious forms, and of cachexy. Before going out in the morning in a marshy country, a (111) of black coffee and a dose of quinine should be taken if a day of extraordinary fatigue or considerable exposure to the sun is foreseen. In order that the preventive quinine may have a really efficacious action, it should be taken in a dose of at least .3 of a gram, and in certain cases it should be increased to .5 of a gram and even .75 of a gram. The diminution in the effects of i)aludism is appreciable only when the sulj)hate of quinine is administered, not in daily, almost homeopathic and insufficient doses, but in relatively large doses, twice a week or when special circum- stances require. During the Madagascar expedition of 1895, quinine was distributed to the men in doses of from .1 to .2 of a gram .during the first four days of the week. In spite of this measure, the fever attacked our soldiers cruelly. It must not be concluded from this, however, that the quinine pre- ventive is useless; it can only be said that the doses were insufficient, or, rather, that the poisoning Avas too violent. Alcoholism is the more formidable because it acts upon the organs weakened by heat and imi)edes digestion, thus aggravating certain diseases, such as paludism and dysen- tery. The rum of the ration ought to be suppressed and ic- placed by tea, which would also make it nece^ssary to boil the water. The English have profited on several expeditions by the su]»pression of rum. The dangers of absinthe and of adulterated li(piors are too well known and to fatal in war not to justify the most rigorous severity against the dealeis. The ]ireventi(Mi of venereal diseases, which ;n-e oiic of the l)lagues of the native i)0])n]ations, (jught to be ;in object of constant Mttention. It would be useful to establish a dispen- Hijgiene of the Soldier in the Tropics. 173 saiy. \'enei-ea'l diseases should not excuse men from work or from taking- part in operations unless they are of exceptional gravity. The patients kept in the cantonment should be "narrowly watched to prev(^nt a propagation of the disease. Every precaution should be taken in regard to variola. The health service will be provided with a quantity of vaccine sufficient to revaccinate all the men. They will be re vacci- nated at the time of embarking or during the course of the vo3'age. The operation should take place in time to allow the pustules to cicatrize before the disembarkation. To prevent the importation of cholera or yellow fever, care should be taken to organize a special sanitary police in the region occupied by the troops. Ships will be examined and a lazaret, provided with disinfection apparatus, should receive the sick who are contaminated. In countries where tetanus is frequent, it will be neces- sary to carefully disinfect all wounds and to use hypodermic injections with circumspection. If all the measures we have just enumerated be scrupu- lously studied and minutely applied, the health of the troops will be greatly profited. 174 Hygiene of fhe tioldier in the Tropics. CHAPTER VIII. Hygienic Principles of a Colonial Army. To one wlio s(M^s things as tliev are, colonial hygiene is in no Avay opj.osed to niilitaiy iiiTeiests. On the eoiitrarj, each jtage of our books sho^vs liow nianv lives have been saved by the sound application of i)iincii)l(^s still too often ignored, and how ex})ensive have been the mistakes. In France, the jirobleni of the organization of a colonial army, so long discussed, seems upon the ])oint of being solved. It is to be feared, however, that the hygienic sid(.' will be subordinated to other considerations, and that the new work will be defectively based. To do it w<^l], new expenses are involved, and the com- pensation to be i-ealized is not sutticiently renicndKMed. Without si)eaking of the economy resulting from a limita- tion of rei)atriation to strict necessity, and from a diminution in diseases and theii- consequences — the human cai)ital is well worth sonielhing. In a country like ouis. whei-e it tends to become more and more rare, it must be husbanded. It should Im- icmembei'ed that nothing is so costly to nations, as to individuals, as discusc, if it is not ilmlh! W'c establish, as a juinciple. what may appear a banal- ity, that lh(^ colonial aiiuy ought to be organized exclusively foi- llic protection and defense of oui- colonies. The crews of the fleet have not been created to tiiilit on land, but to man the sliijis. It is essential thai t his aiuiy be constituted witli a \iew to the occujiation ot our colonial domain, its defense, oi its extension. This should be its princijtal object. How- ever, we jii-esume it would be difticult foi- the country to understand, if, in a continental war, the oiilx elements of our Hygiene of the Soldier in the Tropics. 175 aniiies expeiieiu-ed in campaijiii, and conseciuently possess- inj",' in a liij;li decree the (pialities desired to confront the ter- rible dangers of our futnie wais, should not be s( nt to the frontier, where the fate of the nation ini^lit be decided, if they were at the time available. In case of Enrop«'an contlajiration we could certainly never have too many troops in the colonies. In view of such an eventuality, our foreign possessions should be stionj^ly garrisoned in times of.jteace. In case of trouble in Europe, it would be unwise to send troojjs to the colonies, for, if we are masters of the sea, our cidonies will have little to fear from enterprises of the enemy; in the contrary case, all re- infoicemcnts sent would be seriously comi»romised. The greater part of these elite troojts should therefore be imme- diately utilized at the frontier. The colonial army, having a special end, should have a special organization, and the soldier, who is the ])rincipal part of the machine, ought to be sjiecialized; his career should be that of a specialist, and he should be a ])icked uuin in the full mi^aniug of the word. Everything in our institutions of to-day is opposed to this view and tends to bend ninv creations to the common level. Thus fi-om a sentiment as human as it is patriotic, a single gun-shot caniu)t now be heard without an immediate declaration on the part of every soldier that he is ready for action: each' one wishes to take part in the struggle, to con- front tlu> dangers, and to derive the advantages. Where glory is t(j be con(piered, there is some for all! The error of all this is manifest; in a time of progress and of extreme sjjecialization, the ])rofessioual workman must be always true to his sjiecialty, and the chosen appara- tus adapted to the effect to be produced. To everiione hi^ trade. Now, we affirm that nothing in Eur()])ean waifare, or in 176 Hygiene of the Soldier in the Tropics. its pi-eparatioii, fits the eoiitinental aiiiiy for tropical expe- ditions; moreover, the military life aud operations of our troops in Algiers bear small resemblance to what these ought to be in the colonies. The glorious part played by the troops of the Marine at I>azeilles, in the armies of the Xorth and East, proves, on the other hand, that the soldier who has campaigned in the colonies is adapted to make war upon all battle fields. Tlie reciprocal is not true. So, we believe it is right to demand an autonomous army, adapted to its special functions, and we maintain that if the constitution of the colonial troops is above all a hygienic creation, its recruitment ought to be absolutely by selection. This view has been taken by the English, the Dutch, and the Spanish, and it cannot be said, especially of the first, that they have not succeeded better thaii ourselves in the conduct of their expeditions. If the English use their Britan- nic regiments in their colonies other than India, it is because theirs is an essentially colonial army, by its voluntary enlist- ment, its organization, its traditions, and the marvelous adaptation of the Anglo-Saxon race to new surroundings. It is sufficient, moreover, to see with what scrupulous' care the English form their European detachments for a foreign expedition, to be convinced that with them the prin- ciple. The right man in the right place, is the chief concern. The flag of France has always been ghtriously defended; but the sacrifices have often greatly surpassed the limits of necessity; somethimes they have even been disprojtorfioned to the end in view and the results obtained. It is therefore necessary to determine what should be done to diminish the bloody tithe paid by F"rance for the pro- tection and extension of the colonial domain, and what eco- nomic measui'cs will coiiipeiisiite for the n<'W expenses iiii- Hygiene of the Soldier in the Tropics. 177 posed by the rational organization of a veritable colonial army. § I. Becrvitinij. We have seen what enemies the colonial soldier has to combat, the extraordinary fatigues which sometimes have to be endured, and how necessary it is, in spite of all the pre- cautions taken to protect him, that he should possess the maximum degree of physical resistance, for at certain times he will have no other safeguard. Age. — The tirst condition to exact from the colonial sol- dier is sufficient age. If too young, he is a ready prey to all tropical diseases. F]xpeijence shows that an insufficient bod- ily development unfits him to bear the fatigues of an expedi- tion. If he is robust, he will resist, perhaps, for several years, but will end by succumbing before he is 30. In England, a soldier must be 21 j-ears old and have a year of service before being sent to the colonies; he must be 22 before he is allowed to form part of a column there. In France, we have had soldiers of ll» and even of 18 years of age in the colonies in recent years; many of them have never again seen their native land! Should 21 or 22 years be accepted as the limit? Wv answer formally: Nei- ther the one nor the other, unless great difficulty should be encountered in recruiting with a higher age limit. Indeed, in our opinion, soldiers younger than 23 should not be sent to the colonies. It is only at that age that there is a cer- tainty of complete development. M. Morache goes farther in fixing the inferior age limit for the colonies at 25. According to him, the maximum of resistance to fatigue and to morbid causes is found Ifctween the ages of 25 and 35. From what precedes, we consider it necessary to lav down the principle that soldiers of the colonial armv should 178 Hygiene of ilie Soldier in the Tropics. uot be sent to the eolouies until after they are 22 years old; they could then have finished a certain number of years of service in France or in Algeria. They would thus be doubly tempered by age and by military service. High pay and retirement after fifteen years" service, with proportionate advantages for those whose health would permit a service of only a third or two-thirds of that period, would be sufli- cient to attract and retain the soldiers. We would thus imitate the English in the Indies, the Spaniards in the Philippines, and the Dutch in their Asiatic possessions. Up to 32 years of age, the enlistment would permit every soldier to have finished at least one period of service in France, all being calculated so that the retirements could be made before the age of 45. Nevertheless, a soldier who is 40 years old and has uot attained a non-commissioned grade should be placed in pro- portional retirement, whatever be his time of colonial ser- vice. One grows old quickly in the colonies; soldiers over 40 should not be in the ranks; even that age is an extrerue limit. The most favorable period will always be fi'om 23 to 35 years, and it should be surpassed only in exceptional cases. The old soldier is not, and never has been, what he has been considered. The grognards of Austerlitz and of Waterloo were volunteers of the wars of the Kevolution and many of the soldiers of the Old (iuard had not passed 30 years! If they were old, it was not by reason of age. but because they had lived much war; tliey had seen so much of it: In the colonies, even more than in Eurojjc, the incon- veniences of an age too advanced are the same as those of an age loo young. Old soldiers, as we understand the term, are exccllcin. but soldiers loo old in i/rars arc worthless. Hygiene of ilie Soldier in the Tropics. 179 Condition of Health. — Is it necessary to say that every colonial soldier should jtossess not only the physical qualifi- cations necessary to the soldier of the nietro})olitan army, but should also be in excellent health? A medical connnission, and not one surgeon alone, should examine the men to be enlisted or reenlisted, and it should be the same for the non-commissioned officers. Out- side of the ])orts, this commission could meet at the chief place in each department. The medical leaf of the soldier's hand-book, containing everything of imjjortance connected with his health during his first term of service in the active army, would then be of the greatest aid. The health service as well as the admin- istration would derive great advantage from consulting it. Those enlisted and reenlisted should lie exempt from every constitutional defect: they should be affected neither with consumption, nor rheumatism, nor alcoholism, nor be convalescents from any serious malady whatever. We have seen why a predisposition to tuberculosis should be inquired into; in si)ite of Boudin's theory, that disease is a sure auxiliary of paludism and vice rersa. Dyspeptics, the obese, those with rheumatism and cardi- algia should be eliminated. They are futuje good-for- nothings. It is known how (juickly the digestive functi(ms are influenced by a heat of long duration. The liver and the stomach, then, should be in excellent condition. Even a light attack of these organs is weakening. The repair of the tis- sues is slower, the destruction of the organic poisons is more difficult, especially if the liver, "that great chemist of the system,'' as Ch. Richet has said, is no longer the seat of excre- mentitial activity. The de])loiable tendency of those having rheumatism to become cold is also known, and we have seen 180 Hi/fjienr of the Soldier in the Tropics. that one grows cold in the Tropics quicker thau anywhere else, because there is always an increased propensity to uncover on account of the heat. In these conditions, a light breeze rising after a stilting calm causes a brus(iue modifi- cation of the hygrometric condition of the air sufficiently great to produce great variations in the evaporation from the skin. It is during the winter that these transitions are most frequent, and it is for this reason that the winter sea- son is so unfavorable to those who have rheumatism. It is also necessary to mistrust men subject to local hyperhidrosis, slight but fre(iuent muscular jiains, head- aches, nose-bleed, fluent hemorrhoids, abundant deposits of urates in the urine, habitual eczematous eruptions — -in a word, to the little things making uj) the small change of arthritis. Cardiac hypertrojthies, whatever the cause, even from growth and Independent of all valvular lesion, should be regarded as discpialifying for colonial service. Experience teaches that men thus aff(H-ted, as well as those addicted to the use of alcohol, are the first victims of sun-stroke. Observation has shown that one does not become accli- mated to fever any mor(^ than to dysentery or hepatitis; that, on the contrary, one becomes the more subject to these affec- tions the more the systcan has been pre])ared by former attacks, for no "vaccination" is known wliicli creates inimu nity from them. That is to say, every contirmed victim of paludism, every former sufferer from dysentery, every man having an enlarged liver or spleen, should hnd no place in the colonial contingents. By making it possible for the olficers and surgeons to look for and ascertain organic defects or the presence of morbid geinis, and by obliging the soldier to sei ve at least two veais before admitting him to the first I'eenlistuient. it Hygiene of the Soldier in the Tropics. 181 would-be jiossible to obtain that itM-niitiueiit by selection which is indispensable in the organization of a Rood colonial army. Then the anomalies so fi-eiinent under the system now in vogue would be seen no longer. Young volunteers enlist- ed for five years are now permitted to reenlist for another five years, and are thus found, at the age of 18|, bound to the service for more than nine i/mrs. It is still more regret- table that young men of this catt gory, Avith more than eight years to serve, should be invalided for atfections the germs of which existed at the time of their enlistment and which have developed in the first years of service.* Moral Conditions. — To the conditions of physical vigor represented by suitable age and good health, are joined others of a ditferent nature, but also indisjiensable. Mens Sana in corpore sano, in the broadest sense, could never be bet- ter applied than here to dejjict the union of the physical and moral qualitiei* which should b«^ possessed by the future colonial soldier. Every man serving in the colonies should be a rolnnteer, a man enlisted or reenlisted of his own free will, and on that account naturally w^ell paid. That is what makes the strength of the English and Dutch ccdonial armies. Voluntary enlistment and sufficient age give the men of the Foreign Legion that strength of resistance, that ardor, which makes them such marvelous soldiers, especially in campaign. "The Legion,' says M. de Villebois-Mareuil, ''has a double character: men are enlisted up to the age of 40; it is composed of soldiers by trade, to whom the career of arms *By a decision dated the 15th of May, 1897, the Minister of Marine has fortunately applied a restrictive measure to the provis- ions of the decree of the 4th of August, 1894, which authorized such a state of things; under this decision, the first recnlistment is limited to three years. This makes it possible for a man, six months after his enlistment, to bind himself to service for only seven and a half in place of nine and a half years. 182 Hygiene of the Soldier in the Tropics. is a refuge, the daily bread, often a title of naturalization — that is to say, for a time at least, a veritable profession. In this hybrid organization, which a man enters masked, with- out paper of identity or of nationality, without extract from judicial pigeon-holes, without anything which recommends him or which speaks of his past — there is a strange mixture; but it may be said that from this indefinable whole is evolved an energy of iron, an instinctive passion for adventure, an astonishing fertility of initiative, a supreme disdain for death, all the sublime originalities of raaitial virtues." In spite of this fine portrait, which is a very good one of the legionaire, we do not believe it represents the prototype of the colonial soldier. Some soldiers of the Legion are too old, others too diffi cult to manage. Sublime under fire, stoical in the presence of danger, endowed with an enornu)us resistance to fatigue, they are the first soldiers of the world foi- a strong blow or for an expedition of short duration; but their chiefs know how hard it is for them to bear garrison life and the monot- ony of daily service, and how much discipline costs them, for they possess to a high degree the faults of their generous qualities; love of the unknown, of the new, often leads tlu^se men into strange adventures, especially as nothing exct'jtt the battle-field attaches them to th(^ flag they seive so hero- ically; and tin- adniinisti-ation which has at its disjtosal. in a distant colony, only such elements as this, in face of the natives, njight one day find itself in a situati(»n as annoying as critical. In the colonies, moi-e than in Eui'op(». men of (lood con- dvcl, upon whom the cliief can always count, are needed in the I'anks. Now, it is iuip(»ssiltle to trust, in ordinaiv times, men who see in colonial life only the means of escaping the exigencies of Knropean discipline. Inclined to violate all Hygiene of the Soldier in the Trovics. 183 ordeis, hyoienic rules will not stop them, and their iudocilitj will often expose them, as well as their commanders, to the most eriiel disappointments. Men of bad character durino- their sojourn in France, especially drunkards, ought to be rigorously discarded. In a hot country, the habits of a w^ell-regulated life, of sobriety, are indispensable to the maintenance of discipline. Thus, in certain circumstances, the disciplinaires have rendered service under fire; but they have a resistance much infeiior to that of the other white troops. We have seen that in Senegal, where their mortality was triple that of the other troops. It is true they have been employed in certain colonies on the construction and maintenance of roads; it may doubtless be said, also, that they occupy unhealthy posts in place of free soldiers. Where is the advantage? Have we not natives for the last service? If the disci plinn ires lost three times as many men as the other European corps in Senegal, they had a proportionate number of sick; they are then very expensive, and it is diflicult to understand why the State thus maintains in service, at great expense, troops which are worth less than either the infanterie de marinr or the natives under tire, and are very far from the worth of these in the ordinary conditions of colonial life. The place of these men excluded from the Army ought to be in the military workshops of France, Algeria, and th( colonies, and not in the ranks of the armed contingents. In the campaign in Tapper Senegal, in 1886 and 1887, the mortal- itv among t\\e diseiplinnires was very great. As for recruiting the colonial soldiers among the vaga- bonds, the liabitual criminals, it is to be seen from what pre- cedes how^ little that is to be thought of. Here to morally defective (pialities is joined a physical debility the more acceptuated in the case of these individuals by life in the 184 Hygiene of the Soldier in the Tropics. prisous where they have usually beeu coufined. Anyone who has seen a convoy of c-iiniinals in Xew Caledonia knows that among these worn-out men theie is no longer either activity or energy. The climate would (juickly overcome these mis- erable creatures, who are fitter subjects for the asylum than for the prison or the barracks. We insist, with Doctor ^Nlaurel, u])on the necessity of h.aving in the colonial army, from to]) to bottom, a recruit- ment by selection in I'cgard to moral and intellectual quali- ties. The functions of initiative and responsibility of the oflficers and non-commissioned officers should not be ignored. As to the soldiers, their attitude towards the natives should be a worthy one and their conduct should be irreproachable. They are not sent to the colonics to endanger our inHuence, but, on the contrary, to contribute to its extension. Conditions of T.ace. — It has been thought that men of the warm countries of the south of Europe were more apt to sui»- port the intertropical climates, as trojtical anjiemia has long been considered a thermic anjpmia. Certain facts seem to justify this hypothesis. Abscess of th*' liver is twice as com moil among the French of the North as among those of the South. Thdvenot has observed that yellow fever attacks men of the North in the pro])ortion of five to one of the South. Is it true that the appearance of tro]iical an;emia is slower among the Southerners? It would be bettei-. like Navarre, to attiibute their greater enduiance, their faculty of resistance to disease, to Iheir habitual solwiety: when drinkers, the Soulherners resist liot climates no bettei- than the others In another manner, an iro]»oiiioiial mortality of men of different regions of France, of dilTereiit manners and habits. Hygiene of the Soldier in the Tropics. 185 wliile submitted to the same kind of life and tlie same work. Some interesting observations may be made by con- sidering the mortality among those entering the Navy from the French littoral, from 1S91 to 1805: Algeria and Corsica Mortality 2.20 per 1000 Mediterranean littoral Mortality 6.52 per 1000 Paris and the North littoral Mortality 7.10 per 1000 Region of the Normandy coasts. . .Mortality 9.30 per 1000 Region of the Southwest Mortality 10.40 i)er 1000 Brittany Mortality 13.20 per 1000 The difference between the Corsicans and Provencals, on the one hand, and the Bretons, on the other, is striking. The habits of men have an intluence on mortality much more than the place they come from. It would also be better to take into account the temperament of the individual than his place of origin. According to Corre, the major part of the European elements of the colonial army should be re- cruited among the dark-complexioned; a fair man now and then presents a fine appearance of physical vigor, but to sup- port the fatigues of the service his system needs a too heavy ration of meat. It is to be observed, moreover, that the Eng- lish in India are more often attacked by hepatitis in all degrees than the Spaniards in Cuba and the Antilles. In the question which now occupies us, that of race is one of the most important of all the conditions. Is the acclimatization of the European in the inter- tropical countries p<»ssible? In any a se it is not easy and re- quires great effort. In tropical countries, the European can tive ontij in a weakened state. Lind says: "The men may be likened to vegetables transplanted in foreign soil, where they can be preserved and acclimated only by extraordinary care." Acclnnatization is the ordeal to which the system is sub- jected and with which it pays the ex])enses of becoming 186 Hygiene of the Soldier in flic Tropics. accustomed to the hot coimtry. All the new climatic condi- tions of the tropical countries, to which must often be joined a defective condition of the soil and of the localities inhab- ited, tend to modify the physiological functions of the new arrival. A man who is careful supports the meteorological change easily enough; the telluric influences alone are a formidable danger. This practically coincides with what Felix Jacquot and Dutrouleau have said: "In the various countries, two con- ditions are encountered: the first, irremovable, resulting from the climatological surroundings; the other, accidental and more or less removable; for example, paludal conditions. The European is acclimated to the first, becoming like the natives, who bear them more or less easily; it is only wath great difficulty that he is acclimated to the second.'' New- comers, whether Europeans or natives, pay their tribute to the poison of the marsh, with the difference that the first, debilitated by the climate, aie more accessible to every morbific cause. The Caucasian race has succeeded in acclimating itself in many of the countries of the torrid zone. Where it has not been able to implant itself, the obstacle has been the en- demic diseases born of the soil. It cannot be said that the FrcMich are not acclimated in the Antilles. The emaucii»a- tion of the blacks, by diminishing the fortunes, has done more than to retard European immigration, a numl>er of families having abandoned the colony and i-eturued to France. It has been seen how the Spaniards have acclimated themselves in Cuba and in the Greater Antilles, where the ,000 nativi's. It is well to note that there are native troo^is in only three of our colonies: in Senegal and the Soudan. Indo-China, and Madag-ascai-. It may l:e said, however, that the propor tion of the P^uropeaii eh'inent is still too gi-eat and that it ought to be reduced. Formalion nf llie ('onlingenls. — To obtain this result the ])i-eparatory scheme would be: 1. To oiuanize new native units. Hygiene of the Soldier in the Tropics. 193 2. To use all the t-olouial (H)ntin«;eiits tuinislied bv the local recruitment. 3. To send oulv such European troops as are strictly necessary. To classify these ideas, the service of occnpafion must be distinguished from that of expedition. 1. Service of Occupation. The troops of occupation are those charged with the security of the colony and forming the nucleus of the forces intended to provide for its defense in case of war. It was recently suggested to take the company of //;- fanterie de marine from Guadeloupe, and M. Gerville-Reache rightly opposed the project. As in Algeria, it is necessary to have in our old colonies the nuclei of European troops to suppress troubles before which the (jendarmerie and local police would be found impotent. The last anti-Semitic move- ment in Algeria might be cited in support of this theory. In the end too great a reduction on the score of economy might be bitterh' regretted. However, the service of occupation ought to be assured, in greater part, by the local troops of the country itself, well supplied with European ofUcers, but supported: 1. By European artillery; 2. By gendarmes in sufficient number; 3. By bodies of European infantry in countries not yet fully pacified. In Tong-King, the Soudan, and Madagascar, European troops will be needed for a long time yet and in sufficient number to conduct a campaign, with others in reserve, to guard against eventualities. In the Antilles, Reunion, New Caledonia, Oochin-China, and Senegal a few units of Euro- pean artillery and infantry are alone necessary. i.{ 194 Hiigiene of the Soldier in the Tropics. Ill the paeitied colonies the gendarmes ouj^ht, indeed, to constitute the pi*inei])al force to guarantee security in ordi- nary times. There is already a company of gendarmerie in Guadeloupe, Martini(iu(% Guiana, Reunion, and New Cale- donia, and a detachment in Tahiti. The gendarmes are excel- lent colonial soldiers; they live en famille and take care of their health; it is a tyi)e upon which to model our sendentary soldiers. 2. Expeditions heijoiul the Sea and Depots. To provide this service and at the same time to furnish the reliefs and constitute the necessary cadres for the numer- ous native units, there must be a solid reserve in France, which, wnth the elements present in the colonies, shall con- stitute the colonial army. ^Ve have seen with what elements we would wish to con- stitute it; a word uoav about its organization proper. In France there are as many gendarmes as are wanted; it would probably be possible to have as many Frenchmen as could be desired in the colonial army by offering sufficient advantages to attract men from 22 to .'^2 years of age, desir- ous of enlisting for five years with the ])rivilege of reenlist- ing two or three times, according to ag(^ by offering all who have a taste for a life of adventure an honorable career and sufficient i>ay to jirevent a hesitation on their iiart to em- bracing it. In this manner the countiy would have a body of elite and the means of developing colonization. The system to emi)loy is that of high i)ay, increasing with each reenlistment, i ct ii-euieiit aftei- tifteeii years' service, and concessions of land and eiiiployiiient for tliose wlio wish 1o remain in the colonies. The system of bo-mties Uw enlistment and it'c'Milisiment should be siiiiiiressed as soon as possible, ll is wi-ong. It Hygiene of the Soldier in the Tropics. 195 "would be more logical to base the jiecnniarv advantages upon an increase of pay, or, better still, to reserve the boun- ties for the time when the men leave the Army. The bounty, as now given, is a source of abuse and de bauchery, prejudical to health and discipline. Many soldiers sjiend it within a few days; sometimes it is even spent before being received, because shameless speculators advance the money with usury. The present troops of the Marine, better recruited, in- creased, proliting by the laws, decrees, and regulations which govern the land forces, especially the advantages created by the law of the cadres, provided with all the accessory ser- vices,* could constitute the base of an autonomous colon inJ arnii/, dividtnl into two parts. MOBII^E ORGANIZATIONS OF COLONIAL INFANTRY AND ARTILLERY. Their role should be to furnish the colonial garrisons with oflticers and soldiers; in case of an exj)edition, they should be icady to go, as a whole or by fractions, t(» the colo- nies. Should there be a contim^ntal war, they would consti- tute an army corps to cooperate on the frontier with troops of the land army. Their units should be kept complete; the- officers, non-commissioned officers, and men who compose them should all be ready to take the tield. They should consist of two divisions of infantry, a bri- gade of artillery, and a battalion of colonial engineers. DISTRICT ORGANIZATION. Their rote should be to receive the officers, non-commis sioned officers, and soldiers in excess in the mobile organi- *The colonial army would necessarily have an administrative service and a health service, which should be under control of its commander. The abuses resulting from the separation of the powers have been pointed out by M. Cabart-Danneville. 190 Hygiene of the Soldier in the Tropics. zatious, aud e8[)ecially all sent back from the colonies, a^ long- as their state of health requires. These district organi- zations should also constitute large depots for the mobile organizations; they might be charged with the instructi(»n of the volunteer recruits. There could be taken from these organizations the units maintained at Paris and those which the Government might consider it necessary to maintain at other ]>oints — at Lyons, for example — not only in time of peace, but even during the first days of mobilization, until the arrival of the con- tingents of the territorial army. The district organizations should be stationed in prox imity to the positions they would occupy at the time of mobilization, and, in case of continental war, they would have the mission of assuring, houi the first hour, the defense of the military ports and of their zones of action; they could continue to be used for that defense and to serve as depot-'^ for mobile organizations. Finally, if the nature of the war required, they could furnish the elements of a second arniv cori)s for use on the frontier. In the beginning, the mobile organizations would re- ceive the reserves of the colonial army; the district organiza- tions would receive a part of these reserves and those from the naval lists not utilized by the Marine, who might be turned over to them in time of peace. Two new divisions of infantry, a brigade of artillery, and a battalion of colonial engineers "sxould be iii(lisi)onsable for these distiict organizations. The expePise of uiaintaiuing such a colonial army in Fi-ance in time of j'eace, it is true, would be consideiable if that army comprised only those enlisted for fioni f(uir 1o ti\t' years and the reenlisted; but it must be renu niber<'(l that eaili regiment of iiifdnhiii' and artillrrir do iininiif includes aboui Hygiene of the Soldier in the Tropics. 197 one-fifth of its stiengtli as Loinpaiiv artisaus or meclianics without rank — musicians, clerks, orderlies, employees of va- rious kinds, etc. By reason of the nature of their service, most of these men should be kept in France for several con- secutive years, and should, therefore, be exempt during this time from colonial service. It would be the same for the mobile and district organization** of the colonial army. It would thus l)e indispensable, in order to make all Avho reenlist available for colonial service, to make voluntary enlistments of three jears to occupy these places. Those enlisted in this manner will furnish material for the organi- zation of the colonial army and excellent men for reenlist- ment at the expiration of their term of service. They will take the field with their organizations, in a continental war^ etc., but they should not be sent to the colonies until they have reached the age of 22. The principle that onl.y fully developed men should be sent to the colonies will not be violated by the adoption of this mode of recruiting, which can work concurrently with that of voluntary enlistments for four and five years. Before enumerating the advantages of the system pro- posed, it is proper to recall the changes which have taken place in the infanterie de marine. Different Organizations of the Infanterie de Marine. — At its origin, the infanterie de marine, instituted by decree of the IJrth of May, 1831, comprised two regiments having 58 com- panies in the colonies and 6 depot companies in France, with an effective total of 2.3.S officers and 4000 men. Successively reorganized by the ordinances of the 20th of November, 1838, the 7th of November, 1843, and the 21st of March, 1847; the order of the 24th of August, 1848; the de- cree of the 31st of August, 18.54; the imperial decision of the 8th of Januarv. 1850; the decrees of the 2()th of November, 198 Ili/giene of the Soldier in the Tropics. ISW), the 2(;tli of Janiiaiy, ISSO, and the 1st of March, 1S<)0; this corps to-day includes more than KWIO officers, lio.OdO Eu- ropean troops, and 28,00(» native troops. The Euro|K-an troops comprise 185 companies of infanterie de marine, of which 65 are in the colonies. The native troops comprise 182 companies. These various acts of organization, which do not include those relating to the native corps, may be divided into two groups: the first, from 18:^1 to 1854; the second, from 1851 to 1897. The principle of organization is different for each of these periods. In the tirst period it was possible to supply, well or badly, the colonial relief. The conditions of recruitment were very different from those of to-day, notably since 1868: non-commissioned officers and soldiers were almost exclu- sively volunteer recruits or substitutes — that is to say, re- cruits easy to instruct, or old soldiers, jdaced in organiza- tions W'hose non-commissioned officers had repeatedly served in the colonies. With a personnel thus composed and contingents avail- able for colonial service, it was possible, almost immediately after the call of a class, to have at the dejx'd the same num- ber of companies as in the colonies. When it was impossible to relieve them, men were left in the colonies live or six years, as was the case in the La Plata ex[»edition, the war of the Crimea, and the exjiedition to Mexico. The non-commis- sioned officers and privates passed seven years with tlu' col- ors; many reenlisted or served as substitutes in the corj.s in the colonies themselves. The period of colonial service was foui- years; it was thus only necessary t(^ relieve a (piarter of the garrisons bi-ycuid the sea each year; those who returned to France on account of disease were fewer in a personnel composed of fully devel- Hygiene of the Soldier in the Tropics. 199 oped men and old soldiers. Moreover, the large ett'ective strength in each colony allowed great latitude; vacancies were tilled only once a year, at the time of the relief of the companies, which took place in the most favorable season according to colony, and in accordance with the wise provis- ions of the royal ordinance of the 25th of January, 1828. The causes for changes were much less than they are to-day. In the second period, regiments replaced the depots in the ports and constituted the central portions; moreover, the advantage of having only light troops in the Marine being definitely recognized, the regiments received the armament of the chassevrs a pied. In reality, the decree of the :Ust of August, 185-4, organ- ized the Marine as it existed up to 1890. But the proportion of 70 companies in France to 50 in the colonies, which was sufficient at the time the decree was promulgated to insure the regular relief of the companies and the maintenance of the effectives beyond the sea, was so no longer when it be- came necessary to organize, with the resources of the central portions, expeditionary battalions for the Crimea, Greece, Indq-China, etc. It thus happened that in 1857 there were companies in the Antilles which had left France six years before. The need of large detachments in the Extreme-Orient becoming felt more and more, it was necessary to seek the resources which the metropolis could not furnish in the garrisons of the colonies where order seemed definitely established. In 1859, with a view to remedying this troublesome state of affairs, the number of companies in France was increased and the number of companies in the colonies was reduced; the strength was I2,f>18 men, of whom 8578 were in France, and 4035 in the colonies. The ex])editionary com- 200 Hygiene of the Soldier in the Tropics. ])aiiies were taken t'loiii Fiance; and if one ooes back to all that has been done with this reduced effective sti-eugth, and compares it with what is done at the present time, one is again impressed with this truth: "Only seasoned troops can resist colonial climates; recruits melt like snow." In the first years which followed the reorganization of 1S51), the conditions of colonial service were very good: the men sent from France were instructed and fully developed, the organizations were solid. The decree of the 26th of November, 1809, had the object, while assuring the regular working of the central portions with reference to the reijuirements of our new colonial gar- risons, of harmonizing the organization of the army with the new condition of the law of 1868, which reduced to five years the time the men of the different classes were to pass with the colors. The infanterie de marine was composed of 140 companies, with a total effective of 16,646 men — 8703 in France, and 7943 in the colonies. Thus there was maintained nearly one man in France to one in the colonies. This proportion was far from being sufficient. By rea- son of losses of all kinds and sick-leaves from the depots^ there was a continual deficiency of men, at the i)orts, avail- able for colonial service. Thus the origin of all the diffi- culties of the infanlcrie de marine in ])roviding the colonial reli(^f is to be ascribed to the organization of 1869. At a given moment, the infanterie de marine could not re- lieve th(^ gairisons outside of Euroj)e in a suitable manner, because of the dis])ro])oition betAveen the nund)er of com- l>auics nuiintained in France and the number to be furnished the colonies. This disproportion was still fui-ther increased by the reduction to two vears of the tiujc of seivice in Cochin Thina Hygiene of the Soldier in the Tropics. 201 and Senegal, by the streugtli given to the garrison of New Caledonia, and by the maintenance of a detachment in Toiig-King. The decree of 1880 was the first to admit the principle established by experience, that it was necessary to have in France at least a company and a half in order to maintain one in the colonies. In accordance with that idea, it in- creased the number of companies of infanterie cle marine to 170, with 103 in France and 73 in the colonies, and an effect- ive total of 18,758 men: 11,080 in France and 7072 in the colonies. This proportion, which should never have been dis- turbed, was not long maintained. The constant increase of the colonial garrisons, without corresponding- measures in France, and the creation of a certain number of native corps, the cadres of which were furnished by the infanterie de marine, rapidly destroyed the proportion laid down by the decree of 1880. The decree of the 1st of ^March, 1890, making two regi- ments from one of the infanterie de marine, was especially with the object of applying the fundamental principles of the organization of modern infantry, and the creation of brigades in the ports. At present, the companies maintained in France have an effective of 12,234 men; the colonial garri- sons, in the 05 companies and the cadres of the numerous native regiments, comprise more than 12,000 European troops. The situation is i)recarious, and it is time to apply a rem- edy, if it is not desired to see those whose principal mission is to guard and- defend our colonies, which they moreover helped to conquer, succumb to their troubles. Advantages of the System Proposed. — It does not seem nec- essary to insist upon the advantages which would result to 202 Hygiene of the Soldier in the Tropics. tlie cuviuti y, and also to tlu^ otticeis, uou-couiinitssioued offi- cers, and soldiers, by the adoption of the project we have pro posed for the organization of the colonial army. These advantages may be briefly summarized: the pro- tection or defense of our colonies assured under all circum- stances; the protection of our military ports and their ap- proaches, at the time of declaration of war, from an unex- pected attack of an audacious enemy; the provision of a valuable support, in case of necessity, to the general defense of the territory, by furnishing two elite army corps. This organization would be of great use if the neigh- boring continental powers should again mass troops upon our frontiers and we ourselves should be forced to increase our effectives by the restoration of the fourth battalion of the infantry regiments and by the creation of the 20th army corps. As far as private interests are concerned, the organiza- tion of the colonial army in two large subdivisions would have the advantage of furnishing all the officers and non- commissioned officers necessary to the native troops; it would permit everj' overworked soldier, without change of career, to continue to serve in his own arm with his comrades. The advantages would be especially great for the officers, worn out to-day by the colonial sei-vice, as shown by the losses they sustain. ^loreover, exchanges could be exten sively authorized Ix'tween the elements of the two forma- tions, as they should also lie among the offictMs of the lanil army and those of the colonial army. The relief of the officei-s would be nioi'e (Mpiitable. The actual situation is truly ciitical and is aggravated since our taking possession of Madagascar. In ISO,"), there were Sl:> otticers in France and (JoO in the colonies; 140(5 non-commis- sioned officers in France and 14S4 in the colonies. At pres- Hygiene of the Soldier in the Tropics. 203 ent, we count 775 officers iu Fmuce, against 1201 in the colonies or in Crete, and 1-433 nou-coniniissioned officers iu France against 201>2 in the colonies or in (^rete. Ill these conditions, the length of service in France is eighteen months for colonels, twenty-three months for lieutenant-colonels, sixteen for chiefs of battalion, eighteen for captains, eighteen for lieutenants and sub-lieutenants, fifteen for adjutants, eighteen for sergeant-majors, and six- teen for sergeants. The non-commissioned officers have proportional retire- ment after fifteen years' service; the officers wait twenty-five years— that is to say, they are worn out by the colonial life at the moment when they should be able to take a well- earned repose. If promotion were regular, there would be less complaint; but it is not: assimilation of rank does not exist in the infanterie de marine, as it does in all the other corps in France and in all European armies. The scheme of M. Cabart-Danneville; which provides a officers in France to 2 in the colonies, would be a relief; but the remedy would not be sufficient. The percentage of mortality of the officers, notwithstanding their age and greater comfort, is nearly as great as that of the soldiers. This supports what we have said in regard to tellurism; no person escapes. Tellurism has no respect for rank, and if the officers die as often as their men who go to the colonies too young, it is because thoy go too often and stay too long in the bad conditions. To lessen the hardships of the colonial service, it has been proi)Osed to send officers of the laud army. That would be a great mistake. The colonial army ought to suffice for its task, for all its duties. It would not be just to admit the princii)le that, on the score of economy, officers of the land army could be 204 Hygiene of the Soldier in the Tropics. detached to the colouies, there to occupy places most often piivih'<;ed, and, after a stay of two or three years, reenter their former cori)s, benefiting by the rights of promotion or tlie Legion (Thnnueur, which are only rarely accorded to the officers who consecrate their whole career to this service. It would open the door to favor. As we have said, let ex- changes among the officers of the two armies be considerably facilitated — nothing more: the profit will then be for all, and for the country. Moreover, it is noit true that the special competency nec- essary in the officers who serve in the Trojjics is accpiired very quickly. It cannot be too strongly insisted, with M. Fleury-Kavarin, that there is a necessity for having in our colonial possessions officers of very special aptitude and education. ''We should have a colonial rndre strongly enough constituted to have no need of aid fi'om the metroi)olitan army; the meshes ought to be sufficiently tight to ])revent the passage of any and every body." Finally, there ought to be enrolled in France a sufficient projiortion of the ett'ective strength of the organizations, so that a cry of alarm could be uttered without the fear of being taxed with exaggeration. Regiments which exist only in skeleton form possess no more than the exterior appearance of a military f(U'ce. Leaves at the end of a campaign and the sick-leaves, frecpieut among the reenlisted men often attacked by the dis- eases of the troiiical countries, nmke the regimental effect- ives literally melt away. Certain regiments have at intervals, an almost laugha- ble strength, on account of the vacancies ma; I \'. '/'////(' of Stjjoiirn. There is no fixed duration of the icsistance of the svs- Hygiene of the Soldier in the Tropics. 207 tern in inter-tropical countries. There are jjrreat individual diiferences, greater still according to country. It is known, nevertheless, that in Cochin-China and Senegal the improved conditions in (juartering the troops and the sanitation of the posts have contributed to abate the percentage of mortality, even more than the diminution of tln^ time of sojourn. Actually, the duration of colonial service is fixed as follows: Reenlisteil Enlisted Colonies. for More than for Reenlisted. 3 Years. '.i Years. Antilles, Reunion, New Caledonia, Tahiti 4 years. 8 years. 2 years. Indo-China, Madagascar, Reunion, Senegal, Guiana. 3 years. 2 years. 2 years. Soudan, B^nin 1 year. 1 year. 1 3-ear. Doctor Navarre finds this idea of relief at a fixed date too administrative. It must be acknowledged that, considering the actual conditions of organization it imposes, a uniform sojourn in the colonies would be better. By carefully examining the study we have made of mor tal diseases, the influence of the time of sojourn upon cer- tain affections is apparent; bilious hematuria, sun-stroke, and hepatitis attack a greater proportion of old than of young soldiers, and strike more men at the end than at the beginning of their colonial life. Could this be due to the alcoholic habits unfortunately contracted by too many soldiers, and which are sure to increase with age? That the alcoholic infiucnce upon the genesis of these affections is preponderant is too probable to admit of doubt. If the new basis of recruitment which we have pointed out were adopted, if there w^ere chosen for the colonies only men fully developed and the}' were surrounded by all desira- ble conditions, it is certain that it would be ])ossible to com- 208 Hygiene of Uie Soldier in the Tropics. meuoe increasing the duration of the colonial sojourn, and, according- to the colonies, to fix it at five years in the An- tilles, Reunion, and Oceania; at three years in Indo-China, Madagascar, Guiana, and Senegal; at eighteen months in the Soudan and B^nin. In case health should continue excellent, the sojourn could be prolonged in the three-year colonies until the accomplishment of a fourth or fifth year, without ever pass- ing the latter limit; the human system, in fact, needs to renew its strength in the temperate climates after passing a certain time in the torrid climates, if it is not wished to wear it out, and some day have it succumb to the first attack. Thus, after a maximum sojourn of five years in the colo nies, and beforo, if necessary, every soldiin- who has not set- tled in the colony, whether officer or man, should return to France, should go on leave, and then pass, if still in the ser- vice, into the district organizations. There he would remain the necessary time, returning to the mobile organizations, ready for a new period of service, only when his health per- mitted. Sending troops to a very healthy colony, like New Caledonia, after they have served in a less favoral)le zone like the Soudan, for example, would |)ermit an alternation of the burdens. This would avoid imposing upon anyone in succession, or with an interval of only a year or two, periods of service in an unheaKhy place. This .system is, uutreovei-, in use in the case of our colo- nial functionaries and works well. In default of a better one, we should have recourse to it. \\"\\\ we ever be able to go farther in this way? Will it ever be })Ossible to make our sohliers i-euiain in the colonies, like the P]nglish in India, foi- a |>eriod of twelve years? In the present state of oui- (trgaiii/ation, it is difficult to answei- in (he affirmative; but we have an inmost convictictn Hygiene of the Soldier in the Tropics. 209 that when Ave place our colonial battalions of Toug-Kiug and Madagascai- in the health cities, whence they will descend only temporarily — when we surround them with every de- sirable comfort — nothing- will oppose us in imitating our neighbors. There exist in our new possessions vast regions inhab- ited by warlike i)opulatious, xery jealous of their independ- ence, who still regard us as enemies, and who for a long time yet, perhaps, w'ill not resign themselves to our domina- tion. Among them is naturally the place for those groups, imitating the Roman colonies, which M. Brunet has proposed to constitute, and which would be formed of old soldiers pro- vided with lands in recompense for their services, preserving, moreover, a military organization, and ready in case of need, under regularly appointed chiefs, to defend their property and our flag, with arms in hand. In France, proper attention is far from being given to the utilization of heights for the troops; we believe, however, that it is the most important point in the iiroblem of colo- nization. The solution is to affirm the ]iossibility of individ- ual acclimatization, and at the same time to definitely settle the question of the colonial army, by assuring to all whom it ought to contain, the primordial condition of every individ- ual, as of every institution — Life. CONCLUSIONS. Our work would have been vain, and might have been considered aimless, if, after having enumerated the deaths and enunciated the principal causes of mortality among our colonial soldiers, we had made no effort to seek efficacious remedies. Hygienic statistics relative to service in the Tropics have been given before this, in figures varving between wide ex- 210 Hygiene of the Soldier in the Tropics. tiemes; we have readied a just mean, which, far from allay- ing terror, has dissipated uncertaiuty by reassuring the pes- simists. P^or the first time, we have arrived at conclusions based upon positive data, and, without caring for reflections which are too optimistic, we have told the truth. The number of deaths pointed out is accurate, since it has been drawn from the most authentic sources. The aver- age effective strength has been taken as a basis of estima- tion, and it would be difficult, with the i»recautions employed, to have more exact information. In seeking to establish the causes of mortality, and to make out the proportion for each cause, gaps were to be feared; but, in comjuiring the figures obtained with those of our predecessors, for a century, we have found a reassur- ing conformity. The welcon^e given our first works has shown us that we have been understood and that our manner of seeinc and interpreting facts has been appreciated. It remained for us to show the route to follow to spare the lives of our soldiers; that is the task we have just ful- filled. In approaching this last work. a})prehensions have not been wanting. It was necessary to say nothing wliich liad not been studied, long thought of, and profoundly re- flected upon; for a false indication might have nu'lancholy ^consequences. What we have written has been lived; we have seen what we relate, and the added reflections are stamped with Jlie frankest im])artiality. Our best recompense will be to have done much good, if attention is paid to what we have written. Among the hygienic measures proposed, there are some which depend ujiou I he man himself, who ought to be power- fully aimed f(i!- Ills snuggle against the ti'dpical climate. Hygiene of the Soldier in fJie Tropics. 211 There are ollieis Avbieh depend upon those in command. Tliose in command can never give too much attention to (jiiestions of colonial liygiene, a Ivnowledge of which is as indisjiensable to tliem as that of military strategy. Before assuring victory to our arms, is it not necessary to secure life for those who are to give it? It is primarily from the administration, and still more from the jtublic powers, that one has the right to expect many efforts and great sacrifices. All the (piestions relative to the recruitment and organization of the colonial troops, to their (piartering, ecpiipment, and alimentation, to the f^res required by their state of health, in peace as in war, are so many problems whose prompt solution is imposed upon the representatives of the country. We have jjointed out the means best calculated, in our opinion, to hasten the rc^alization of these several desiderata; it is for others to act now. ^lay the statesmen understand the grandeur of the roJe devolved upon their ]iatriotism! If France Inis hitherto given much gold for the effica- cious expansion of her colonial domain, she has also been largely prodigal of the blood of her children I The hour has come to change all this. P^nough corpses have been thrown, sometimes uselessly and without measure, into the balance under juetext of making it incline in our favor; exjjenses will not be useless, if their ( nd is t<^ preserve lives. 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